The effect of message framing on self-management of chronic pain: a new perspective on intervention?

This study examines framed messages as a novel approach to promote self-management of chronic pain. Primary care patients reporting chronic pain (pain rated ≥?4 on 0-10 NRS-I for ≥3 months) were randomly assigned to receive a gain- or loss-framed message promoting self-management of pain. Impact of the framed message on behavioural self-management (including communicating with providers, relaxation, activity pacing, pleasant activities and healthy lifestyle) was assessed. Post-message, individuals in the loss-frame condition reported significantly greater interest in and more knowledge gained from the information presented in the message (p≤0.03). Loss-frame participants were significantly more likely to express confidence that they would practice relaxation (p≤0.03). Pain readiness to change, pain self-efficacy and message frame independently influenced motivation to engage in relaxation as a self-management strategy. Across all behaviours assessed, there were no observed interactions between message frame and either pain self-efficacy or pain readiness to change (p>0.05). Framing may be useful to promote pain self-management; larger trials are needed to fully evaluate its potential and to further assess the applicability of framed communication to impact a broader range of chronic conditions.     

Medicare's search for effective obesity treatments: diets are not the answer

The prevalence of obesity and its associated health problems have increased sharply in the past 2 decades. New revisions to Medicare policy will allow funding for obesity treatments of proven efficacy. The authors review studies of the long-term outcomes of calorie-restricting diets to assess whether dieting is an effective treatment for obesity. These studies show that one third to two thirds of dieters regain more weight than they lost on their diets, and these studies likely underestimate the extent to which dieting is counterproductive because of several methodological problems, all of which bias the studies toward showing successful weight loss maintenance. In addition, the studies do not provide consistent evidence that dieting results in significant health improvements, regardless of weight change. In sum, there is little support for the notion that diets lead to lasting weight loss or health benefits.     

When You Care Enough to Do Your Very Best: Genetic Counselor Experiences of Compassion Fatigue

Compassion fatigue is a phenomenon that occurs when a caregiver feels overwhelmed by repeated empathic engagement with distressed clients (Figley, 2002). Research demonstrates its existence among nurses, physicians, and mental health professionals, but to date no published study has specifically investigated the nature and prevalence of compassion fatigue among genetic counselors. The present study was an initial attempt to identify and describe the phenomena in genetic counseling by conducting focus group interviews with 12 genetic counselors. Data analysis yielded several themes: a) compassion fatigue occurs and may compromise professional and personal functioning; b) prevalent triggers include delivering bad news and difficult patient issues (e.g., terminal illness, anger, psychopathology); c) effective coping strategies include consulting with colleagues, setting boundaries, and humor; and d) risk factors include personality characteristics and traumatic memories. Training, practice, and research recommendations are provided.