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Impact of an Acceptance Facilitating Intervention on Patients’ Acceptance of Internet-based Pain Interventions

A Randomized Controlled Trial

Baumeister, Harald PhD*,†; Seifferth, Holger MSc*; Lin, Jiaxi MSc*,†; Nowoczin, Lisa MSc*; Lüking, Marianne Dipl. Psych; Ebert, David PhD§,∥

The Clinical Journal of Pain: June 2015 - Volume 31 - Issue 6 - p 528–535
doi: 10.1097/AJP.0000000000000118
Special Topics Series

Objective: Results from clinical trials indicate that Internet-based psychological pain interventions are effective in treating chronic pain. However, little is known about patients’ acceptance of these programs and how to positively influence patients’ intention to engage in them. Therefore, the present study aimed (1) to assess patients’ acceptance of Internet-based interventions, and (2) to examine whether patients’ acceptance can be increased by an acceptance facilitating intervention.

Methods: A total of 104 patients with chronic pain from 2 pain units were randomly allocated to an intervention group (IG) and a no-intervention control group (CG). The IG was shown a short informational video about Internet-based psychological pain interventions before receiving a questionnaire on patients’ acceptance of Internet-based psychological pain interventions and predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, Internet usage, and Internet anxiety). The CG filled out the questionnaire immediately. Patients’ acceptance was measured with a 4-item scale (sum score ranging from 4 to 20).

Results: Baseline acceptance of Internet-based interventions was reported as low (sum-score:4-9) by 53.8%, moderate (10 to 15) by 42.3%, and high (16 to 20) by 3.9% of the patients with chronic pain in the CG. The IG showed a significantly higher acceptance (M=12.17, SD=4.22) than the CG (M=8.94, SD=3.71) with a standardized mean difference of d=0.81 (95% CI, 0.41, 1.21). All predictor variables were significantly improved in the IG compared with the CG, except for Internet usage.

Conclusions: Patients with chronic pain display a relatively low acceptance of Internet-based psychological pain interventions, which can be substantially increased by a short informational video.

*Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg

Department of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg

Interdisciplinary Pain Center, University Medical Center, Freiburg

§Division Health Trainings online, Leuphana University, Lueneburg

Department of Psychology, Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany

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This study was partly funded by the German statutory pension insurance scheme (project “Internet-based health interventions: state of research and implementation possibilities for the medical rehabilitation”).

H.B. initiated this study. H.B., H.S., J.L., L.N., and D.E., contributed to the design of this study, developed the intervention content, and the assessment. H.S. was responsible for patient recruitment. H.S. and H.B. wrote the draft of the manuscript. M.L. provided expertise on chronic pain and psychological pain interventions. All authors contributed to the further writing of the manuscript and approved the final version of the manuscript.

The authors declare no conflict of interest.

Reprints: Harald Baumeister, PhD, Engelbergerstr. 41, D-79085 Freiburg, Germany (e-mail:

Received December 9, 2013

Received in revised form May 21, 2014

Accepted April 28, 2014

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