Welche Rolle spielt die Veränderungsmotivation des Transtheoretischen Modells (TTM) für das Ausmaß der Beeinträchtigung durch chronische Schmerzen bei Patienten mit rheumatischen Erkrankungen?

Abstract

BACKGROUND: Motivation in the concept of the Transtheoretical Model (TTM) is the readiness to make a change of attitudes and behaviour and is essential for effective self-management of chronic pain. According to this patients pass through different stages of change (precontemplation, preparation, action, maintenance) before they adopt a new behaviour (e. g., relaxation exercise). The present study evaluates how the four stages of change differ in terms of pain variables in patients with chronic pain. METHODS: Different questionnaires (pain disability in social, family and job-related domains, self-efficacy expectations and the German version of the Pain Stages of Change Questionnaires (PSOCQ), the FF-STABS were administered two times to 147 patients of a rehabilitation clinic. Statistical analysis of variance (SPSS-procedure GLM) was used to analyse the relevance of the stages of change for pain variables. RESULTS: The main effect of the multivariate analysis of variance shows significant differences between the four stages of change for the dimension pain disability (p = 0.001; F = 2.422; df = 21). Pain-related self-efficacy was increased in higher stages (p = 0.003; F = 4.903; df = 3). Via post-hoc tests the stage of change maintenance differed significantly in contrast to precontemplation, preparation and action in terms of pain disability in social, family and job-related domains. Further studies are recommended to investigate the validity of the stages of change model with respect to other pain-related dimensions, because the stages precontemplation, preparation and action could not always distinguished precisely.