Qualitative evaluation of the SMART2 self-management system for people in chronic pain

Geoffrey Duggan, Edmund Keogh, Gail Mountain, Paul McCullagh, Jason Leake, Christopher Eccleston

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Technology could support the self-management of long-term health conditions suchas chronic pain. This article describes an evaluation of SMART2, a personalised selfmanagementsystem incorporating activity planning and review, feedback on behaviour- andacceptance-based therapeutic exercises. Method: The SMART2 system was evaluated over afour-week trial in the homes of people in chronic pain. At conclusion, participants wereinterviewed to understand the experience of using and living with the SMART2 system as atherapeutic tool. Results: Qualitative analysis of the interviews found that participants liked thesystem and reported making associated changes to their behaviour. Goal setting and feedbackwere the most useful elements of the system. A third key and unexpected element was that bysimulating some of the functions of a therapist, SMART2 also simulated some of the process ofinteracting with a therapist. Conclusions: People in chronic pain may experience positiveoutcomes when using a self-management system designed for behaviour change. Furthermore,some of the supportive aspects of the therapeutic context can be elicited by self-managementtechnologies.
LanguageEnglish
Pages53-60
JournalDisability and rehabilitation. Assistive technology
Volume10
Issue number1
DOIs
Publication statusPublished - 1 Jan 2015

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Self Care
Chronic Pain
Interviews
Technology
Health
Therapeutics

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Duggan, Geoffrey ; Keogh, Edmund ; Mountain, Gail ; McCullagh, Paul ; Leake, Jason ; Eccleston, Christopher. / Qualitative evaluation of the SMART2 self-management system for people in chronic pain. In: Disability and rehabilitation. Assistive technology. 2015 ; Vol. 10, No. 1. pp. 53-60.
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title = "Qualitative evaluation of the SMART2 self-management system for people in chronic pain",
abstract = "Technology could support the self-management of long-term health conditions suchas chronic pain. This article describes an evaluation of SMART2, a personalised selfmanagementsystem incorporating activity planning and review, feedback on behaviour- andacceptance-based therapeutic exercises. Method: The SMART2 system was evaluated over afour-week trial in the homes of people in chronic pain. At conclusion, participants wereinterviewed to understand the experience of using and living with the SMART2 system as atherapeutic tool. Results: Qualitative analysis of the interviews found that participants liked thesystem and reported making associated changes to their behaviour. Goal setting and feedbackwere the most useful elements of the system. A third key and unexpected element was that bysimulating some of the functions of a therapist, SMART2 also simulated some of the process ofinteracting with a therapist. Conclusions: People in chronic pain may experience positiveoutcomes when using a self-management system designed for behaviour change. Furthermore,some of the supportive aspects of the therapeutic context can be elicited by self-managementtechnologies.",
author = "Geoffrey Duggan and Edmund Keogh and Gail Mountain and Paul McCullagh and Jason Leake and Christopher Eccleston",
note = "Reference text: 1. Breivik H, Collet B, Ventafridda V, et al. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006;10:287–333.2. Eccleston C, Williams ACDC, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev 2009;(2):CD007407. 3. Khan N, Bower P, Rogers A. Guided self-help in primary care mental health: meta-synthesis of qualitative studies of patient experience. Br J Psychiatry 2007;191:206–11. 4. Andersson G. Using the internet to provide cognitive behaviour therapy. Behav Res Ther 2009;47:175–80. 5. Murray E, Burns J, See TS, et al. Interactive health communication applications for people with chronic disease. Cochrane Database Syst Rev 2005;(4):CD004274. 6. Car J, Huckvale K, Hermens H. Telehealth for long term conditions. BMJ 2012;334:e4201. 7. Currell R, Urquhart C, Wainwright P, Lewis R. Telemedicine versus face to face patient care: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2010;(2):CD002098. 8. Wantland DJ, Portillo CJ, Holzemer WL, et al. The effectiveness of web-based vs. non-web-based interventions: a meta-analysis of behavioral change outcomes. J Med Internet Res 2004;6:e40. 9. Bender JL, Radhakrishnan A, Diorio C, et al. Can pain be managed through the internet? A systematic review of randomized controlled trials. Pain 2011;152:1740–50. 10. Palermo TM, Wilson AC, Peters M, et al. Randomized controlled trial of an internet-delivered family cognitive-behavioral therapy intervention for children and adolescents with chronic pain. Pain 2009;146:205–13. 11. Velleman S, Stallard P, Richardson T. A review and meta-analysis of computerized cognitive behaviour therapy for the treatment of pain in children and adolescents. Child Care Hlth Dev 2010;36:465–72. 12. Ritterband LM, Thorndike FP, Cox DJ, et al. A behaviour change model for internet interventions. Ann Behav Med 2009;38:18–27. 13. Newell AF, Gregor P. User sensitive inclusive design – in search of a new paradigm. Proceedings of A.C.M. Conference on Universal Usability. Washington, DC; 2000:39–44. 14. Rosser BA, McCullagh P, Davies R, et al. Technology-mediated therapy for chronic pain management: the challenges of adapting behaviour change interventions for delivery with pervasive communication technology. Telemed J E Health 2011;17:211–16. 15. Eng TR, Gustafson DH, Henderson J, et al. Introduction to evaluation of interactive health communication applications. Science Panel on Interactive Communication and Health. Am J Prev Med 1999;16:10–15. 16. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77–101. 17. Hayes SC, Luoma JB, Bond FW, et al. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther 2006;44: 1–25. 18. Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore 1994;23:129–38. 19. McCracken LM, Volwes KE, Eccleston C. Acceptance of chronic pain: component analysis and a revised assessment method. Pain 2004;107:159–66. 20. Brooke J. SUS: a ‘‘quick and dirty usability scale’’. In: Jordan PW, Thomas B, Weerdmeester BA, McClelland AL, eds. Usability evaluation in industry. London: Taylor and Francis; 1996:189–94. 21. Borkovec TD, Nau SD. Credibility of analogue therapy rationales. J Behav Ther Exp Psychiatry 1972;3:257–60. 22. Locke EA, Latham AP. Building a practically useful theory of goal setting and task motivation. Am Psychol 2002;57:705–17. 23. Warsi A, LaValley MP, Wang PS, et al. Arthritis self-management programs: a meta-analysis of the effect on pain and disability. Arthritis Rheum 2003;48:2207–13. 24. Newman S, Steed L, Mulligan K. Self-management interventions for chronic illness. Lancet 2004;364:1523–37. 25. Griffiths C, Foster G, Ramsay J, et al. How effective are patient (lay led) education programmes for chronic disease? BMJ 2007;334: 1254–6. 26. Rosser BA, Vowles KE, Keogh E, et al. Technologically assisted behaviour change: a systematic review of studies of novel technologies for the management of chronic illness. J Telemed Telecare 2009;15:327–38. 27. Reeves B, Nass C. The media equation: how people treat computers, television, and new media like real people and places. Cambridge: Cambridge University Press; 1996. 28. Epley N, Waytz A, Cacioppo JT. On seeing human: a three-factor theory of anthropomorphism. Psychol Rev 2007;114:864–86.",
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Qualitative evaluation of the SMART2 self-management system for people in chronic pain. / Duggan, Geoffrey; Keogh, Edmund; Mountain, Gail; McCullagh, Paul; Leake, Jason; Eccleston, Christopher.

In: Disability and rehabilitation. Assistive technology, Vol. 10, No. 1, 01.01.2015, p. 53-60.

Research output: Contribution to journalArticle

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AB - Technology could support the self-management of long-term health conditions suchas chronic pain. This article describes an evaluation of SMART2, a personalised selfmanagementsystem incorporating activity planning and review, feedback on behaviour- andacceptance-based therapeutic exercises. Method: The SMART2 system was evaluated over afour-week trial in the homes of people in chronic pain. At conclusion, participants wereinterviewed to understand the experience of using and living with the SMART2 system as atherapeutic tool. Results: Qualitative analysis of the interviews found that participants liked thesystem and reported making associated changes to their behaviour. Goal setting and feedbackwere the most useful elements of the system. A third key and unexpected element was that bysimulating some of the functions of a therapist, SMART2 also simulated some of the process ofinteracting with a therapist. Conclusions: People in chronic pain may experience positiveoutcomes when using a self-management system designed for behaviour change. Furthermore,some of the supportive aspects of the therapeutic context can be elicited by self-managementtechnologies.

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