THU0648-HPR STUDY OF PAIN ATTITUDES &amp; BELIEFS BETWEEN RHEUMATOLOGISTS, PHYSICAL THERAPISTS AND PATIENTS FOR FIBROMYALGIA- A CROSS-SECTIONAL SURVEY
Authors: S. K. Paramasivam, C. S. Kumar
Journal: Annals of the Rheumatic Diseases (2020)

Background: Attitudes and beliefs about pain determine the interpersonal interaction in evaluation and treatment of a chronic painful condition like fibromyalgia in a multidisciplinary healthcare system. Two distinct dimensions for pain attitudes and beliefs were identified as Biomedical and Behavioral. The former utilized a pathoanatomical model whereas the latter incorporated the psychosocial factors into clinical presentations. Objectives: The study aimed to evaluate the pain attitudes and beliefs amongst rhematologists, physical therapists and fibromyalgia patients and to compare the biomedical and behavioral dimensions between the three groups in study population of fibromyalgia syndrome (FMS). Methods: A nation-wide cross-sectional survey (online and direct interviews) was conducted between 2010-16 to identify first group- 18 (16 male, 2 female) rheumatologists (snowball sampling), and second group- 122 (44 male, 78 female) physical therapists (purposive sampling), both with previous experience of treating adults with fibromyalgia. Also 188 patients with FMS were also studied from outpatient departments of tertiary care hospitals as the third group. All participants filled the Pain Attitudes and Beliefs (PABS) scale and the scores were analysed to identify the two dimensions descriptively in percentiles, and their between-group comparisons were done using Chi-Square test at 95% confidence interval using SPSS version 22 for Windows software. Results: There was an overall predominance of biomedical dimension for FMS reported in all three groups, with rheumatologists being most prevalent (76.8%), followed by patients (65.6%) and then by physical therapists (54.12)%. Between-group comparisons were significant (p&lt;.05) for all 6 analyses. Conclusion: Biomedical dimension was predominantly reported by rhematologists, physical therapists and patients for chronic pain in FMS and this necessitates further research on development and implementation of educational interventions in this part of the world. References: [1] Kumar SP , Jim A. Physical therapy in palliative care: from symptom control to quality of life: a critical review. Indian J Palliat Care. 2010;16(3):138-46. [2] Kumar SP , Jim A, Sisodia V. Effects of Palliative Care Training Program on Knowledge, Attitudes, Beliefs and Experiences Among Student Physiotherapists: A Preliminary Quasi-experimental Study. Indian J Palliat Care. 2011;17(1):47-53. [3] Kumar SP , Saha S. Mechanism-based Classification of Pain for Physical Therapy Management in Palliative care: A Clinical Commentary. Indian J Palliat Care. 2011;17(1):80-6. [4]Prem V, Karvannan H, Chakravarthy R, Binukumar B, Jaykumar S, Kumar SP . Attitudes and Beliefs About Chronic Pain Among Nurses-Biomedical or Behavioral? A Cross-sectional Survey. Indian J Palliat Care. 2011;17(3):227-34. [5] Kumar VK, Kumar SP , Baliga MR. Prevalence of work-related musculoskeletal complaints among dentists in India: a national cross-sectional survey. Indian J Dent Res. 2013;24(4):428-38. [6]Kumar SP , Kumar A. Evidence-based Practice in Chronic Pain: A Multidimensional Biopsychosocial Paradigm is the “Need of the Hour” in Palliative Care. Indian J Palliat Care. 2013;19(2):126-7. [7]Kumar SP , D’souza M, Sisodia V. Interpersonal communication skills and palliative care: “finding the story behind the story”. Indian J Palliat Care. 2014;20(1):62-4. Acknowledgments: Study participants for their whole-hearted participation and contribution. Disclosure of Interests: None declared