Background & Aims
Online therapeutic patient education (e-TPE) groups have become increasingly popular in recent years, particularly since the COVID-19 health crisis. Although empirical data suggest the effects of these devices, few studies have explored the evaluation of psychological processes and the therapeutic experience by the patient and the group during these programs. A validated multidisciplinary e-TPE program, in line with international recommendations about the management of fibromyalgia, has been adapted for e-TPE at the Pain Assessment and Treatment Centre of the Saint-Antoine University Hospital Centre in Paris (France). It includes 9 weekly 1.5-hour videoconference sessions. The objectives are to improve somatic (medical: reduction in pain intensity, etc.), behavioral (kinesitherapy: reconditioning to muscular effort, etc.) and psychological (pain acceptance, stress reduction, etc.) criteria.
Methods
The exploratory longitudinal interventional study adopts a mixed qualitative and quantitative methodology. The objectives are to have a better understanding of the group experience, session after session, in terms of therapeutic leverage promoting patient empowerment and quality of life.
Data collection for the e-TPE groups took place at the pain center at Saint-Antoine University Hospital Centre (AP-HP) in 2020-2021. The e-TPE sessions were recorded, transcribed and analyzed using a phenomenological approach (inductive approach) focused on speech analysis. Questionnaires and scales measuring pain intensity (VAS), pain management (CSQ-F), anxiety (HAD) and quality of life (QIF “well being” item) were administered pre- and post-TPE and e-TPE. TPE group data were extracted from medical records. A statistical analysis of variance (ANOVA repeated measures) was performed using Jamovi software to identify the therapeutic effects in both conditions (TPE and e-TPE) on these measures.
Results
The e-TPE group of 14 women (mean age > 40 years old) was compared with the TPE group (matched control group) of 14 women (mean age > 40 years old). The results showed no difference in the impact of fibromyalgia on quality of life between the two conditions. Pain VAS (most/least intense, and usual pain), and anxiety measures showed no significant difference between the two conditions. Only the dramatization variable was significant (p < 0.05) in the CSQ-F, and showed a superior effect of the e-TPE group. Qualitative phenomenological analysis highlighted recurring themes specific to group dynamics (group cohesion, support figures), as well as investment in therapeutic education activities (reintroduction of physical activity, modification of body image, notion of pleasure, listening to oneself and one's limits).
Conclusions
In conclusion, the analysis of the questionnaires shows few differences between TPE and e-TPE groups. On the other hand, phenomenological qualitative analysis of group dynamics confirms the value of e-TPE in leading the patient to therapeutic change. The therapeutic experience through telehealth seems to have therapeutic effects and to increase patient empowerment when e-TPE is based on group dynamics. The therapeutic value of the telehealth experience therefore merits further study.
References
Climent-Sanz, C., Gea-Sánchez, M., Moreno-Casbas, M. T., Blanco-Blanco, J., García-Martínez, E., & Valenzuela-Pascual, F. (2020). A web-based therapeutic patient education intervention for pain and sleep for women with fibromyalgia: A sequential exploratory mixed-methods research protocol. Journal of advanced nursing, 76(6), 1425–1435.
Kohns, D. J., Urbanik, C. P., Geisser, M. E., Schubiner, H., & Lumley, M. A. (2020). The Effects of a Pain Psychology and Neuroscience Self-Evaluation Internet Intervention: A Randomized Controlled Trial. The Clinical journal of pain, 36(9), 683–692.
Mehta, S., Peynenburg, V. A., & Hadjistavropoulos, H. D. (2019). Internet-delivered cognitive behaviour therapy for chronic health conditions: a systematic review and meta-analysis. Journal of behavioral medicine, 42(2), 169–187.
Paolucci, T., de Sire, A., Ferrillo, M., di Fabio, D., Molluso, A., Patruno, A., Pesce, M., Lai, C., Ciacchella, C., Saggino, A., Agostini, F., & Tommasi, M. (2022). Telerehabilitation proposal of mind-body technique for physical and psychological outcomes in patients with fibromyalgia. Frontiers in physiology, 13, 917956.
Presenting Author
Anne Masselin-Dubois
Poster Authors
Anne Masselin-Dubois
PhD
Université de Bourgogne Franche-Comté / Laboratoire, Psy-DREPI EA-7458
Lead Author
Lucie Sebillotte
University Hospital Center of Dijon, France
Lead Author
Lou Perrot
Laboratory Psy-DREPI EA-7458 - University of Burgudy, France
Lead Author
Christian Guy-Coichard
Pain centre - Saint Antoine Hospital - APHP, Paris, France
Lead Author
Françoise Laroche
Pain centre - Saint Antoine Hospital - APHP - INSERM U987, Paris, France
Lead Author
Topics
- Education