Pain and Health Beliefs in Rehabilitation Outpatients

Detailed Description:

This cross-sectional analytical study was designed to evaluate the interrelationships between pain beliefs, health beliefs regarding complementary and alternative medicine (CAM), and spiritual well-being in patients attending a Physical Medicine and Rehabilitation (PMR) outpatient clinic.

Rationale:

Chronic musculoskeletal pain is among the most frequent reasons for PMR admission. Prior research has examined pain beliefs, CAM utilization, or spirituality separately, yet little is known about their combined influence on patient coping, psychological status, and treatment orientation. Understanding these multidimensional factors is essential for advancing holistic, patient-centered rehabilitation strategies.

Study Design and Methods:

The study was conducted at Yozgat Bozok University, Faculty of Medicine, Department of PMR. A cross-sectional analytical design was employed. Eligible participants were adults aged 18-65 years who were literate, cognitively intact, and consented voluntarily. Exclusion criteria included communication or cognitive impairments, refusal to participate, or age outside the inclusion range.

Assessments:

Participants completed standardized, validated Turkish versions of the following instruments:

Hospital Anxiety and Depression Scale (HADS): evaluation of anxiety and depression symptoms.

Pain Beliefs Questionnaire (PBQ): assessment of organic and psychological pain beliefs.

Complementary, Alternative, and Conventional Medicine Attitude Scale (CACMAS): evaluation of attitudes toward CAM and conventional medicine.

Complementary and Alternative Medicine Health Belief Questionnaire (CHBQ): assessment of CAM-related health beliefs.

Three-Factor Spiritual Well-Being Scale (TFSWBS): measurement of transcendence, harmony with nature, and anomie.

Statistical Plan:

Descriptive statistics were calculated for demographic and clinical variables. Group comparisons were performed using Student's t-test, ANOVA, or chi-square tests, as appropriate. Correlation analyses explored associations among psychological, cognitive, and spiritual outcomes. Multiple regression models were applied to identify predictors of CAM health beliefs and spiritual well-being. Sample size was determined a priori using G*Power (version 3.1.9.7) to achieve 95% power with five predictors at α = 0.05.

Expected Contribution:

By integrating cognitive, psychological, and spiritual dimensions, the study seeks to clarify how pain beliefs and CAM health beliefs relate to spiritual well-being in rehabilitation patients. Findings are expected to support the incorporation of structured spiritual assessments and evidence-based CAM counseling into PMR practice to enhance holistic pain management.

Inclusion criteria

• Adults between 18 and 65 years of age
• Attending the Physical Medicine and Rehabilitation outpatient clinic
• Able to read and write
• Cognitively intact
• Voluntarily willing to participate and able to provide informed consent

Exclusion criteria

• Younger than 18 years or older than 65 years
• Illiterate individuals
• Individuals with cognitive impairment
• Individuals with communication difficulties
• Patients who declined to participate or had incomplete data