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Attitudinal responses to current concepts and opinions from pain neuroscience education on social media

PainSci » bibliography » Weisman et al 2022

PainSci commentary on Weisman 2022: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This is a study of the attitudes of social media users about “pain neuroscience education,” which is the generic concept better known from the book title “Explain Pain,” an approach to treating persistent pain with confidence-building education about the nature of the beast.

It’s small study with significant limitations (clearly acknowledged by the authors), but it’s actual data that echoes my own impressions of what patients say about PNE both publicly, and what my readers say privately to me (like this good example I blogged about). So the data backs up a conclusion I had already tentatively arrived at:

People with persistent pain tend to express negative attitudes to PNE statements.

Unsurprisingly, they are also more likely to be unhappy about PNE than the professionals delivering PNE. As I have been arguing for 20 years, the clinicians who choose to use a methodology are the last to find out that patients don’t like it.

“The possible problematic nature of PNE statements should be acknowledged,” the authors write. Agreed, that possibility should be acknowledged. Patient dissatisfaction with a modality isn’t necessarily a deal-breaker, but it is certainly one of those “things that make you go hmmmm.” 🤔

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: Pain neuroscience education (PNE) programs have become popular among clinicians and are widely promoted through social and mainstream media.

PURPOSE: To test the hypothesis that people with persistent pain are likely to express negative attitudes to PNE statements and compare their responses to other social media user groups.

METHODS: A total of 1319 respondents completed an online survey and were directed into four groups: persistent pain, healthcare professionals with persistent pain, pain-free healthcare professionals, and pain-free controls. The survey included ten statements of popular PNE concepts. Feedback was invited by offering seven attitudinal response categories (three positives, three negatives, and one neutral). A two-step hierarchical regression model was used to assess the likelihood of reporting negatively.

RESULTS: Compared to controls, respondents from the persistent pain group were more likely to report negatively towards all statements (OR 1.6-2.16), except for two statements (#3 and #5). Healthcare professionals were less likely to report negative attitudes for 4 out of 10 statement (OR 0.35-0.58). Health care professionals living with persistent responded to most statements like the pain-free controls (besides statement #2, OR 0.59).

CONCLUSION: People living with persistent pain are more likely to express negative attitudes to PNE statements on social media, unlike healthcare professionals who were less likely to express negativity. Healthcare professionals living with persistent pain responded to most PNE statements like the pain-free control group. The study's main weaknesses include the lack of psychometric information of the questionnaire used, selection bias, small samples of the healthcare professionals and the overrepresentation of young social media users.

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