[Measuring the willingness of chronic pain patients to change pain management behavior - a study on the transtheoretical model].

Research Question: The transtheoretical model (TTM) describes the willingness of behavior change as a process characterized by six stages: precontemplation, contemplation, preparation, action, maintenance, and termination. This study investigates the possibility to apply the TTM to the treatment of chronic pain patients. The main goal is the development of items for a self-administered instrument, which documents the willingness to use cognitive-behavioral methods for pain management independently. With this instrument a treatment can be assigned according to the patient's motivation in order to improve outcomes of pain management programs.

Methods: Based on TTM theory 56 items were developed and adminstered to a sample of 118 chronic pain patients, who were recruited via different facilities for pain therapy. Item- and factor analysis were conducted for determining psychometrical attributes of items and latent scales.

Results: Analyses resulted in four consistent scales and accordingly four distinctive stages: precontemplation, preparation, action, and maintenance, which showed sufficiently high indices of homogeneity and discriminant validity. The relationships between scale scores and sociodemographic and pain related variables proved to be in accordance to the theory.

Conclusions: The results show transferability of the TTM to pain management in general. Two stages, contemplation and termination, could not be identified yet. Mainly termination seems not to be existent in the context of pain management. A further study should confirm these findings before therapeutical interventions can be assigned more specifically by the motivational preparedness.