Agency orientation and chronic musculoskeletal pain: Effects of a group learning program based on the personal construct theory

Objective: This study evaluated the effects of a group learning program on patients with chronic musculoskeletal pain and high absenteeism and investi gates what characterizes those patients who may benefit from such a program . The learning program was based on personal construct theory. The theory i ncluded the following: (1) participation in an educational program is relat ed to a favorable outcome across the outcome measures (pain, pain coping, m anagement of daily life, absenteeism, and use of health care), (2) patients with high agency orientation (i.e., inner-directed) cope with their pain a nd manage daily life in a better manner than do patients with low agency or ientation (i.e., outer-directed), and (3) patients with high personal contr ol, measured in terms of agency orientation, in terms of health locus of co ntrol, or in both terms, will benefit more from the educational program tha n will patients with low personal control. Design: The study was a randomized controlled study. Patients: One hundred and sixteen patients with chronic musculoskeletal pai n and high absenteeism answered a questionnaire before and after the interv ention program. The intervention group (n = 61) consisted of nine subgroups geographically spread through the eastern part of Norway and met for four hours every 2 weeks from February 1997 to October 1997. A total of 12 meeti ngs were held. Results: The intervention group reported a significantly higher score for t he variable "management of everyday life" (p <0.005) and for the variable " health care consumption" (p <0.001) than did the control group. Patients wi th high agency orientation benefited more from the program with regard to p ain reduction and improved pain coping than did those patients with low age ncy orientation (p <0.05). Patients with high agency orientation also repor ted less absenteeism than did those patients with low agency orientation (p <0.05).