Using Intervention Mapping to Develop a Novel Pain Self-Management Intervention for People with Cirrhosis

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2022 Feb 11

PMID 35147816

Authors

Shari S Rogal

Matthew J Chinman

William Demonte

Sandra Gibson

Stephanie Hoyt-Trapp

Gloria J Klima

Naudia L Jonassaint

Jane M Liebschutz

Kevin L Kraemer

Jessica Merlin

Affiliations

Soon will be listed here.

Abstract

Background: Chronic pain is common among patients with cirrhosis and is challenging to treat. While promising, pain self-management (PSM) interventions have not been tailored to this population's needs.

Aims: To design a PSM intervention for patients with cirrhosis.

Methods: Semi-structured interviews with 17 patients with cirrhosis, 12 hepatologists, and 6 administrators from two medical centers were conducted to inform a rigorous, structured intervention mapping (IM) process. Qualitative content analysis was guided by social cognitive theory (SCT) and the Consolidated Framework for Implementation Research (CFIR) and incorporated into intervention development. A planning group met regularly throughout the intervention, to reach consensus about how to use data and theory to develop the intervention through IM.

Results: Participants described barriers to PSM behaviors, including the absence of simple, evidence-based interventions for pain for patients with cirrhosis, inadequate provider knowledge, time, and training, and lack of champions, funding, and communication. Patients described high motivation to treat pain using behavioral methods including meditation, prayer, and exercise. The intervention was designed to address barriers to PSM behaviors for patients with cirrhosis, using behavior change methods that address knowledge, self-efficacy, and outcome expectations. The LEAP (Liver Education About Pain) intervention is a 12-week, modular intervention delivered by phone via individual and group sessions with a health coach.

Conclusions: People with cirrhosis, hepatologists, and administrators informed this theory-driven, tailored PSM intervention, which was designed to be implementable in the real world.

Citing Articles

Using Intervention Mapping and Behavior Change Techniques to Develop a Digital Intervention for Self-Management in Stroke: Development Study.

Wong A, Fong M, Munsell E, Metts C, Lee S, Nicol G JMIR Hum Factors. 2023; 10:e45099.

PMID: 37486748 PMC: 10407772. DOI: 10.2196/45099.

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