Monday, March 2, 2020

Interstitial Cystitis Part VI

Treatment Modalities: Psychological Strategies
Though perhaps not widely understood or considered, psychological strategies and techniques can offer potential benefits to those suffering from pain disorders by aiding patients in the development of better coping strategies and transforming underlying pain beliefs.49
In a study of 138 participants with an IC diagnosis, patients were surveyed to determine the use and effectiveness of psychological self-care strategies in the management of symptoms.50 Following review of results, researchers concluded that women suffering from IC engaged in a number of psychological self-care such as downward comparison, self-validation, empowerment, information-seeking, connection with others and taking personal responsibility for illness.50 Results demonstrated improved ability to cope depended upon the use of  information-seeking, downward comparison, empowerment, connection with others and self-validation.50 Of most significance, researchers stated that involvement in a support group was perhaps the most important strategy employed.50
A study of 108 subjects with pain-related distress and disability participated in several acceptance-based strategies to determine effectiveness in dealing with pain.51 Treatment tools centered around increasing patient willingness to deal with uncomfortable thoughts and feelings and instead focusing attention on behaviors that encourage improved functioning in the long term rather than caving to a momentary feeling.51 In addition, physical exercise, health habits and meaningful life directions were addressed as components of therapy.51 Researchers concluded that the pain and functional ability of the patients improved significantly at post-treatment and at three month follow-up when compared to pre-treatment.51 More specifically, improvements across participants included 41.2% improvement in depression, 25% improvement in physical disability, 39.9% improvement in psychosocial disability, 61.8% reduction in hours needed to rest as a result of pain during daytime hours, and 48.2% improvement in the ability to repeatedly perform sit-to-stand endeavors.51  Researchers stated that psychological methods for dealing with chronic pain have significant evidence to support their effectiveness yet confirmation of  particular treatment modalities that lead to improvement are lacking.51 Further, researchers stated that an acceptance-based treatment approach challenges the pain experience overall and offers a very promising avenue for further development in the management of pain.51

49. Atchley MD, Shah NM, Whitmore KE. Complementary and alternative medical therapies for interstitial cystitis: an update from the United States. Translational Andrology and Urology. 2015; 4(6): 662-667. 
50. Webster DC, Brennan T. Use and effectiveness of psychological self-care strategies for interstitial cystitis. Healthcare for Women International. 1995; 16(5): 463-75.
51. McCrackena LM, Vowlesb KE, Eccleston C. Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour Research and Therapy. 2005; 43: 1335–1346.

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