A test of Braden's Self-Help Model in adults with chronic pain

To test hypothesized relationships in Braden's Self-Help Model in a sample of people with idiopathic chronic pain. Testing theoretical explanations and predictions with various clinical populations under different sociocultural, economic, climatic, and health system environments provides evidence about the applicability of the underlying theory among diverse populations.

This study was part of a larger randomized, controlled trial of a community-based nursing psycho-educational intervention: the Chronic Pain Self-Management Program (CPSMP). Pretest and posttest data were collected in 1995-1996 in Newfoundland, Canada.

Participants completed a battery of valid and reliable self-report instruments to measure pain, disability, uncertainty, resourcefulness, self-efficacy, adult role behaviors, and life satisfaction. Two tests of the self-help model were performed, the first with pretest data (N = 110) and the second with 3-month posttest data (N = 102) after half the sample had participated in the CPSMP intervention. Causal modeling path analysis was done with the Statistical Package for the Social Sciences (SPSS) program and tests of goodness-of-fit were conducted using EQS for Windows.

Results supported the overall hypothesized pattern of relationships in the self-help model. Amounts of variance explained in the two major outcomes of the model (self-help: 42% to 53% and life quality: 45% to 47%) were consistent with results from other studies. Indices of goodness of fit showed an adequate fit of the model to the data, particularly the posttest data.

Braden's Self-Help Model appears to be robust in a variety of clinical populations, among different settings and environmental conditions, and provides a useful framework to guide nursing psycho-educational interventions in chronic illness.