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Publication

Pain science education after breast cancer surgery

Book - Dissertation

The Belgian Cancer Registry reported 10,905 new female breast cancer patients in 2018. Despite the fact that successful screening, early intervention and improved treatment options have improved breast cancer survival, 90% of survivors suffer lifelong sequelae. These long-term complications are a major issue since they substantially impair daily life functioning and quality of life. Pain is one of the most frequently reported side effects of breast cancer treatment and affects all aspects of functioning, including physical activity, upper limb use and return to work. As a result, adequate pain management during the early stages of breast cancer treatment is essential for resolving and preventing these issues, both in the short and long term.Over the last few decades, there has been a greater understanding of the important role of educational interventions in the management of pain. However, they mainly focus on tissue injury as the source of pain and are often restricted to biomedical pain management instructions. Increased knowledge on pain mechanisms has only recently resulted in a more modern educational approach, also known as pain science education. The educational content explains that pain is not always a true representation of the actual state of the tissues, but that it is the nervous system's interpretation of the threat of their injury, which can be influenced by a variety of psychosocial factors. By zooming out of the purely biomedical vision on pain, pain science education aims for a reconceptualization from a biomedical or structural model to an actual biopsychosocial one. Patients who understand that tissue injury is not the only factor causing pain, but that stress, sleep, social interactions, previous pain experiences and physical activity, among other things, can also influence the pain experience (meaning that pain could be experiences without tissue damage), may be more likely to participate in activities that they previously avoided because of pain. This could improve the effectiveness of commonly used physical therapy modalities for the treatment and prevention of pain-related disabilities after breast cancer treatment.The existing evidence for the potential benefits of pain science education in non-cancer pain populations, along with the lack in methodologically strong studies on this topic in breast cancer patients, led us to the main research objective of this PhD research project, which was to investigate the effectiveness of pain science education in improving pain-related disability after breast cancer surgery. More specifically, the research aims of this PhD project were formulated as follows:1. To conduct a systematic review on the effectiveness of perioperative pain science education in improving pain, psychological factors and physical functioning in adults who underwent surgery2. To examine the psychometric properties (including validity and reliability) of the PDI-DLV one year after surgery for breast cancer3. To conduct a randomized controlled trial to evaluate the effectiveness of postoperative pain science education compared to biomedical pain education in improving pain-related disability, physical activity and upper limb functioning after breast cancer surgery4. To investigate the effect of postoperative pain science education in breast cancer patients on return to work by means of a randomized controlled trial
Publication year:2021
Accessibility:Embargoed
Embargoed until:07/09/2023