Purpose: Preliminary evidence suggests that a self-guided cognitive and behaviourally-based pain management intervention (PROSPECT) is effective for chronic painful chemotherapy-induced peripheral neuropathy (CIPN), but its mechanism of action is unknown. The purpose of this secondary analysis was to explore if changes in anxiety, depression, sleep-related impairment, or fatigue mediated improvements in worst pain following PROSPECT in individuals with chronic painful CIPN.
Methods: Sixty participants were randomized to receive self-guided cognitive behavioural pain management (access for eight weeks) or treatment as usual. A seven-day worst CIPN pain diary and the PROMIS measures of anxiety, depression, fatigue, and sleep-related impairment were administered pre/posttest (eight-weeks). Causal mediation analysis was used to quantify mediators of worst pain improvement.
Results: None of the hypothesized mediators had a statistically significant effect on worst pain (n=38).
Implications: Further research is needed to identify potential mediators of pain intensity that can be targeted by specific cognitive behavioural strategies to improve painful CIPN severity.
Source :Canadian Oncology Nursing Journal/Revue canadienne de soins infirmiers en oncologie, 28(3), 178-183.
Author: Knoerl, R., Barton, D. L., Holden, J. E., Krauss, J. C., LaVasseur, B., & Smith, E. M. L. (2018).http://www.canadianoncologynursingjournal.com/index.php/conj/article/view/910