Chronic musculoskeletal pain disorder patients: different levels of treatment expectations

Abstract

In patients with chronic musculoskeletal pain (CMP), treatment expectations at intake have been reported to predict outcomes after inpatient care. This study aimed to further describe the internal components of treatment expectations, as well as the influencing factors related to each component. Data from 403 inpatients with CMP treated in two tertiary A-level hospitals in Lanzhou City from June to December 2022, and all patients completed a series of psychological questionnaires at intake. Treatment expectation was evaluated at intake using the Patient-Centered Outcome Questionnaire (PCOQ), while the Hospital Anxiety and Depression Scale (HADS), Fear Avoidance Beliefs Questionnaire (FABQ), Pain Catastrophizing Scale (PCS), General Self-Efficacy Scale (GSES), Barthel Index (BI), and 20-item Toronto Alexithymia Scale (TAS-20) were also measured at intake. The treatment expectations of patients with CMPDs can be classified into three subgroups: “low-symptom and low-expectation”, “high-symptom and insecure-expectation”, and “high-symptom and high-expectation”, with BI, FABQ, Anxiety, and PCS identified as their influencing factors; The importance of symptom improvement can be separated into three subgroups: “High importance”, “Moderate importance except for low emotional distress and interference with daily activities”, and “Moderate importance except for low fatigue”, which are affected by the number of hospitalizations, quality of life, and FABQ. Interventions may be directed toward the characteristics that influence the treatment expectations of patients with chronic musculoskeletal pain, in order to adjust unrealistic (too high or too low) treatment expectations, and the findings might help clinicians manage patients with CMPDs more effectively.