Culturally Sensitive Pain Education Program for Turkish Patients
Condition: Chronic Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      In last decade, the awareness has grown regarding the pain neuroscience education (PNE). In
      the literature, it has been found that there is strong evidence that the educational strategy
      of pain neuroscience education (PNE) can have positive effects on pain, disability,
      catastrophization, and physical performance in chronic musculoskeletal disorders. Nowadays,
      many physiotherapists integrate the PNE into the treatment of chronic pain. However, the
      importance of culturally sensitive approaches for the treatment of chronic pain has been
      proposed depending on the cultural differences of pain beliefs, pain cognitions, pain
      experiences and pain coping strategies in different ethnic populations. Therefore, the aim of
      this study is to compare the effects of a culturally sensitive PNE with a standard translated
      PNE on pain intensity, disability status, pain pressure thresholds and psychosocial factors
      (conceptualization of pain, pain beliefs, catastrophizing, kinesiophobia and illness
      perception) in Turkish patients with chronic low back pain (LBP).

      The effects of culturally sensitive PNE format will be compared with the standard translated
      PNE in a pilot trial. 40 Turkish patients (first generation migrant living around Ghent) with
      chronic LBP, between the age of 18 and 65 years, will be randomized to the culturally
      sensitive PNE or standard translated PNE. The content of 2 sessions PNE include the
      explanation about differences of acute and chronic pain, purpose of acute pain, production of
      acute pain and chronic pain, and potential sustaining factors for central sensitization, but
      presented in different ways. They will be subjected to an individual education session and
      they will receive a home education program. In session 2 (after 1 week), they will come back
      to ascertain that everything is understood.
    

Detailed description: 
      In last decade, the awareness has grown regarding the pain neuroscience education (PNE). In
      the literature, it has been found that there is strong evidence that the educational strategy
      of pain neuroscience education (PNE) can have positive effects on pain, disability,
      catastrophization, and physical performance in chronic musculoskeletal disorders. Nowadays,
      many physiotherapists integrate the PNE into the treatment of chronic pain. However, the
      importance of culturally sensitive approaches for the treatment of chronic pain has been
      proposed depending on the cultural differences of pain beliefs, pain cognitions, pain
      experiences and pain coping strategies in different ethnic populations. Therefore, the aim of
      this study is to compare the effects of a culturally sensitive PNE with a standard translated
      PNE on pain intensity, disability status, pain pressure thresholds and psychosocial factors
      (conceptualization of pain, pain beliefs, catastrophizing, kinesiophobia and illness
      perception) in Turkish patients with chronic low back pain (LBP).

      The effects of culturally sensitive PNE format will be compared with the standard translated
      PNE in a pilot trial. 40 Turkish patients (first generation migrant living around Ghent) with
      chronic LBP, between the age of 18 and 65 years, will be randomized to the culturally
      sensitive PNE or standard translated PNE. The content of 2 sessions PNE include the
      explanation about differences of acute and chronic pain, purpose of acute pain, production of
      acute pain and chronic pain, and potential sustaining factors for central sensitization, but
      presented in different ways. They will be subjected to an individual education session and
      they will receive a home education program. In session 2 (after 1 week), they will come back
      to ascertain that everything is understood.

      The primary outcomes include pain intensity and disability status. Secondary outcome measures
      are pain pressure thresholds and psychosocial factors such as conceptualization of pain, pain
      Beliefs, catastrophizing, kinesiophobia and illness perceptions. Pain thresholds will be
      assessed with the pressure algometer. Pressure will be applied bilaterally at 3 pressure
      points: one on the mass of erector spinae muscle, one on the quadriceps muscle, and one on
      the trapezius muscle. All outcomes will be evaluated at baseline, day 7 (immediately after
      session 2) and after 1 month follow-up.
    

Intervention name(s): Culturally sensitive pain education; Standard pain education program
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The content of the PNE program include the characteristics of acute and chronic pain, purpose of acute pain, formation process of acute pain from the nervous system, the formation process of chronic pain, and potential sustaining factors for central sensitization.; For the standard translated PNE, The English translation of "Pain Neuroscience Education: slides for supporting and illustrating your explanation" at the Pain in Motion Group web page (http://www.paininmotion.be/education/tools-for-clinical-practice) and English translation of the Patient Information Leaflet will be used. The education materials will be translated using the forward/backward translation process. The English version of PNE presentation and information leaflet will be translated to Turkish by two independent translators.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment