Ward, S., Donovan, H., Gunnarsdottir, S., Serlin, R.C., Shapiro, G.R., & Hughes, S. (2008). A randomized trial of a representational intervention to decrease cancer pain (RIDcancerPain). Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 27(1), 59–67.
To determine if the changes associated with the RIDcancerPain program—in regard to beliefs, coping, pain severity, and pain-related interference—are greater than the changes associated with standard education
Subjects were randomized to the control group or the intervention group. The control group received attention and standardized information about pain. Information was basic. The control group received a booklet, in question-answer format, that provided a review of common misconceptions about pain and information about managing the side effects of opioids. The intervention consisted of one session. Coverage of each subject during the session lasted 20–60 minutes. Patients were asked to describe beliefs about cancer pain (cause, timeline, consequences, cure, and control). The intervener identified and discussed misconceptions, provided accurate information, and cited the benefits of implementing changes based on the information provided. Patients discussed misconception-related limitations and losses. After the intervention (2–3 days later), patients in the intervention group had the opportunity to ask questions and provide comments via telephone, in a conversation with the research nurse. Patient-related baseline measures were gathered by means of self-report questionnaires that had been mailed to the patient prior to the intervention. Measures were also gathered at 1 and 2 months.
Randomized controlled trial
The RIDcancerPain intervention reduced measured patient barriers to pain management and usual pain severity but demonstrated no effect on other measures of pain severity, coping, pain-related interference with life, or overall well-being.
Findings suggest that providing the information specified in the RIDcancerPain program can be beneficial in terms of overcoming known barriers to effective pain management. However, the effect of the program on overall pain control remains unclear: Findings suggest that time and attention may be the most important factors in dealing with barriers to pain management. (In the intervention group, the period in which effects were greatest was shortly after individualized sessions and follow-up calls.)