Implementing a cognitive-behavioral pain self-management program in home health care, part 1: program adaptation

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Pain Management

Background:

• Pain is a widespread issue for older adults in home care, leading to disability and reduced quality of life.
• Existing pain management in home care is often insufficient, leaving a vulnerable population with persistent pain.
• Cognitive-behavioral pain management shows promise but isn't widely used in home health settings.

Purpose of the Study:

• To adapt an existing community-based cognitive-behavioral pain self-management program.
• To tailor the program for physical therapists (PTs) to use with home care patients experiencing activity-limiting pain.
• To address the need for effective pain management strategies in the home care environment.

Main Methods:

• An observational study involved training two groups of home care PTs in the community-based program.
• PTs provided input via surveys and discussions on program components, modifications, and training needs.
• Expert panels reviewed workshop data to finalize program adaptations for home care implementation.

Main Results:

• Seventeen experienced PTs participated in the training and provided valuable feedback.
• Key modifications included reducing session numbers, altering content, revising exercises, and updating patient materials.
• Therapist training protocols were also modified for the home care context.

Conclusions:

• A group-based pain management program was successfully adapted for delivery by healthcare providers in home care settings.
• The described adaptation process can serve as a model for implementing evidence-based programs in new environments.
• Further details on field-testing the adapted program are available in a companion article.