Prediction of outcome: Are you satisfied? An examination of satisfaction and treatment outcome measures in an interdisciplinary functional restoration program for patients with chronic pain

Abstract

Despite previous patient reports that reductions in pain severity are necessary for successful treatment, elimination or reduction of pain is not necessarily sufficient to explain patient satisfaction concerning treatment. Yet, satisfaction of patients is an important variable with regard to several treatment domains. Patient satisfaction has been found to be related to adherence to treatment and treatment plans, as well as active patient involvement. Moreover, satisfaction serves as a measure of quality assurance, permitting not only valuable feedback from patients, but also an evaluation of the treatment. Given that the sample being utilized consists of patients who have generally failed numerous treatment efforts and tend to be treatment refractory, patient satisfaction may be of particular importance in this population. Furthermore, despite the overall effectiveness of a functional restoration program (FRP) regarding return to work and associated treatment goals, these patients generally are significantly distressed and report high levels of pain. Such variables are likely to affect not only overall treatment success, but also satisfaction levels. Given the potential relation between these variables and patient satisfaction, correlation coefficients were computed among residualized change scores of the scales on the Multidimensional Pain Inventory and demonstrated functional capability with overall satisfaction scores for 150 chronic pain patients participating in an intensive FRP. While correlations revealed no relation between satisfaction scores and changes in pain severity or functional capability, satisfaction was related to increases in general activity levels (r=.21, p=<.01) and decreases in affective distress levels (r=-.24, p=<.01). Moreover, a stepwise regression analysis revealed that changes in affective distress were predictive of overall treatment satisfaction scores (F=8.49, p=<.01). These results support the view that changes in pain intensity and function are not sufficient to explain patient satisfaction. In fact, satisfaction may be a unique construct that is more accurately predicted by psychosocial variables.