Readiness to adopt the self-management approach to cope with chronic pain in fibromyalgic patients

The effectiveness of cognitive-behavior therapy aimed at helping patients w ith the acquisition of self-management skills to cope with pain, is thought to depend partly on the patients' willingness to adopt a self-management a pproach. Some patients may not believe that selfmanagement will be helpful while others have decided to adopt it and others already apply the self-man agement skills in their daily lives. The present study explored the concept of 'Readiness to change' in a population of Dutch fibromyalgic patients. A self-report questionnaire was completed by 321 patients. Factor analysis r evealed three scales, each assessing the characteristic of one stage of rea diness to change, the Precontemplation, Contemplation and Action scale. Fir stly, the reliabilities of these scales were 0.61, 0.86 and 0.61, respectiv ely, and only the latter two scales correlated significantly (r = 0.14). Se condly, the scales were validated using subscales from the Multidimensional Pain Inventory, beliefs on the credibility of the self-management approach and subscales from the Illness Perception Questionnaire. These subscales e xplained 5, 22 and 8% of the variance of the scores on the Precontemplation , Contemplation and the Action scales, respectively. Thirdly, on the basis of the three scale scores, over 80% of the fibromialgia patients could be c lassified into one of five potentially psychological relevant subgroups: Pr econtemplation, Contemplation, Preparation, Action and Relapse. The data su ggest that improvements in operationalizations of the Precontemplation and Action dimensions of readiness to change are needed and that the theoretica l foundation of readiness to change needs further development. (C) 2001 Int ernational Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.