Advertisement

From chronic pain patient to peer: Benefits and risks of volunteering

      Abstract

      Peer volunteers have been used as cost-effective adjuncts to professional services in other settings and populations, but not a heterogeneous sample of patients with chronic pain. This study evaluated the transition from “patient” to “peer,” identifying possible benefits or harm associated with volunteering. Peers provided descriptive data and questionnaires, including measures of pain, disability, self-efficacy, and depression before and after three periods: as a patient, during training, and while volunteering. Average pain intensity scores declined while participants were patients (7.1 to 4.2), rose slightly (5.8) before training, and dropped again after training and volunteering (4.3 and 3.6, respectively). A similar pattern was noted for disability. Depression scores continued to decline after initially dropping, and self-efficacy scores remained stable after the initial 40% rise as a patient. Two themes, “making a connection” and “a sense of purpose,” emerged from the narrative data. Descriptive data provided further support that volunteering benefited both patients and peers. This study supports the viability of using peer volunteers for clinical or research endeavors. Improvements in pain, disability, and depression were reported immediately after training and after volunteering for several months without evidence of harm. Despite encountering challenges, the rewards of this altruistic endeavor outweighed any frustrations experienced by volunteers with chronic pain. © 2002 by the American Society of Pain Management Nurses
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Pain Management Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Acute Pain Management Guideline Panel
        Acute pain management: Operative or medical procedures and trauma..
        Clinical Practice Guideline. : Public Health Service, Rockville, MD1992 (Agency for Health Care Policy and Research (AHCPR) Publication No 92-0032)
        • Anderson K.O.
        • Dowds B.N.
        • Pelletz R.E.
        • Edwards W.T.
        Development and initial validation of scale to measure self-efficacy beliefs in patients with chronic pain.
        Pain. 1995; 63: 77-84
        • American Pain Society (APS)
        Chronic pain in America: Roadblocks to relief.
        (Retrieved October 1, 2001, from)
        • Appelbaum K.A.
        • Blanchard E.B.
        • Hickline E.J.
        • Alfonso M.
        Cognitive behavioral treatment of a veteran population with moderate to severe rheumatoid arthritis.
        Behavioral Therapy. 1988; 19: 489-502
        • Arnstein P.M.
        • Caudill M.
        • Mandle C.L.
        • Norris A.
        • Beasley R.
        Self efficacy as a mediator of the relationship between pain intensity, disability, and depression in chronic pain patients.
        Pain. 1999; 80: 483-491
        • Bandura A.
        Self efficacy: The exercise of control.
        : W. H. Freeman and Company, New York1997
        • Becker F.
        • Zarit S.H.
        Training older adults as peer counselors.
        Educational Gerontology. 1978; 3: 241-250
        • Bradley L.A.
        • Young L.D.
        • Anderson K.O.
        • Turner R.A.
        • Agudelo C.A.
        • McDaniel L.K.
        • Pisko E.J.
        • Semble E.L.
        • Morgan T.M.
        Effects of psychological therapy on pain behavior of rheumatoid arthritis patients.
        Arthritis and Rheumatism. 1987; 30: 1105-1114
        • Burns M.
        Creating a safe passage: The meaning of engagement for nurses caring for children and their families.
        Issues in Comprehensive Pediatric Nursing. 1994; 17: 211-221
        • Byrd M.
        Personal growth aspects of peer counselor training for older adults.
        Educational Gerontology. 1984; 10: 369-385
        • Centers for Disease Control and Prevention
        Prevalence, and impact of arthritis by race and ethnicity – United States, 1989-1991.
        MMWR. 1996; 45: 373-388
        • Chinball J.T.
        • Tait R.C.
        The pain disability index: Factor structure and normative data.
        Archives of Physical Medicine and Rehabilitation. 1994; 75: 1082-1086
        • Connelly L.M.
        • Bott M.
        • Hoffart N.
        • Taunton R.L.
        Methodological triangulation in a study of nurse retention.
        Nursing Research. 1997; 46: 299-302
        • Craft C.
        A conceptual model of feminine hardiness.
        Holistic Nursing Practice. 1999; 13: 25-34
        • Dorfman L.T.
        Health conditions and perceived quality of life in retirement.
        Health and Social Work. 1995; 20: 192-199
        • Elliott A.M.
        • Smith B.H.
        • Penny K.I.
        • Smith W.C.
        • Chambers W.A.
        The epidemiology of chronic pain in the community.
        Lancet. 1999; 354: 1248-1252
      1. Back pain in the workplace: Management of disability in nonspecific conditions. . IASP Press, Seattle1995
        • French S.A.
        • Leffert N.
        • Story M.
        • Neumark-Sztainer D.
        • Hannan P.
        • Benson P.L.
        Adolescent binge/purge and weightloss behaviors: Associations with developmental assets.
        Journal of Adolescent Health. 2001; 28: 211-221
        • Gaston-Johansson F.
        • Fridh G.
        • Turner-Norvell K.
        Progression of labor pain in primiparas and multiparas.
        Nuring Research. 1988; 37: 86-89
        • Geisser M.E.
        • Roth R.S.
        • Robinson M.E.
        Assessing depression among persons with chronic pain using the Center for Epidemiological Studies-Depression Scale and the Beck Depression Inventory: a comparative analysis.
        Clinical Journal of Pain. 1997; 13: 163-170
        • Glanz K.
        • Marger S.M.
        • Meehan E.F.
        Evaluation of a peer educator stroke education program for the elderly.
        Health Education Research. 1986; 1: 121-130
        • Gray R.
        • Fitch M.
        • Davis C.
        • Phillips C.
        A qualitative study of breast cancer self-help groups.
        Psychooncology. 1997; 6: 279-289
        • Gronblad M.
        • Jarvinen E.
        • Hurri H.
        • Hulpi M.
        • Karaharju E.O.
        Relationship between the Pain Disability Index and the Oswestry Disability Questionnaire with three dynamic physical tests in a group of patients with chronic low-back and leg pain.
        Clinical Journal of Pain. 1994; 10: 197-203
        • Harris R.M.
        • Kavanaugh K.H.
        • Hetherington S.E.
        • Scott D.E.
        Strategies for AIDS prevention: Leadership training and peer counseling for high-risk African-American women in the drug user community.
        Clinical Nursing Research. 1992; 1: 9-24
        • Hitchcock L.S.
        • Ferrell B.R.
        • McCaffery M.
        The experience of chronic nonmalignant pain.
        Journal of Pain and Symptom Management. 1994; 9: 312-318
        • Ho E.E.
        • Waltz J.
        • Ramstack J.
        • Kligman E.
        • Meredith K.
        • Cohen R.
        • Meyskens F.
        Health-peers: A delivery model for health-promotion among the elderly.
        Educational Gerontology. 1987; 13: 427-436
        • Keefe F.J.
        Can cognitive-behavioral therapies succeed where medical treatments fail?.
        in: Proceedings of the 9th World Congress on PainProgress in pain research and management. 4. 2000: 1069-1084
        • Keefe F.J.
        • Caldwell D.S.
        Cognitive behavioral control of arthritis pain.
        Medical Clinics of North America. 1997; 81: 277-290
        • Keefe F.J.
        • Affleck G.
        • Lefebvre J.C.
        • Starr K.
        • Caldwell D.S.
        • Tennen H.
        Pain coping strategies and coping efficacy in rheumatoid arthritis: A daily process analysis.
        Pain. 1997; 69: 35-42
        • Keefe F.J.
        • Caldwell D.S.
        • Williams D.A.
        • Gil K.M.
        • Mitchell D.
        • Robertson C.
        • Martinez S.
        • Nunley J.
        • Beckham J.C.
        • Helms M.
        Pain coping skills training in the management of osteoarthritic knee pain II: Follow-up results.
        Behavioral Therapy. 1990; 21: 435-447
        • Kistin N.
        • Abromson R.
        • Dublin P.
        Effect of peer counselors on breastfeeding initiation, exclusivity and duration among low-income urban women.
        Journal of Human Lactation. 1994; 10: 11-15
        • Klepp K.I.
        • Halper A.
        • Perry C.L.
        The efficacy of peer leaders in drug abuse prevention.
        Journal of School Health. 1986; 56: 407-411
        • Kruger J.M.
        • Helmick C.G.
        • Callahan L.F.
        • Haddix A.C.
        Cost-effectiveness of the arthritis self-help course.
        Archives of Internal Medicine. 1998; 158: 1245-1249
        • Lindsey E.
        Health within illness: Experiences of chronically ill/disabled people.
        Journal of Advanced Nursing. 1996; 24: 465-472
        • Lorig K.
        • Lubeck D.
        • Kraines R.G.
        • Seleznick M.
        • Holman H.R.
        Outcomes of self-help education for patients with arthritis.
        Arthritis and Rheumatism. 1985; 28: 680-685
        • Lorig K.R.
        • Mazonson P.D.
        • Holman H.R.
        Evidence suggesting that health education for self management in patients with chronic arthritis has sustained health benefits while reducing health care costs.
        Arthritis and Rheumatism. 1993; 36: 439-446
        • Luna G.C.
        • Rotheram-Borus M.J.
        Youth living with HIV as peer leaders.
        American Journal of Community Psychology. 1999; 27: 1-23
        • Matthews D.A.
        • Suchman A.L.
        • Branch Jr., W.T.
        Making “connexions:” Enhancing the therapeutic potential of patient-clinician relationships.
        Annals of Internal Medicine. 1993; 188: 973-977
        • McGrath P.A.
        An assessment of children's pain: A review of behavioral, physiological and direct scaling techniques.
        Pain. 1987; 31: 147-176
        • McGrath P.A.
        • Seifert C.E.
        • Speechley K.N.
        • Boot J.C.
        • Stitt L.
        • Gibson M.C.
        A new analogue scale for assessing children's pain: An initial validation study.
        Pain. 1996; 64: 435-443
        • Meenan R.F.
        Epidemiology and health services research.
        Current Opinion in Rheumatology. 1993; 5: 129-131
        • Moore J.E.
        • Von Korff M.
        • Cherkin D.
        • Saunders K.
        • Lorig K.
        A randomized trial of a cognitive-behavioral program for enhancing back pain self care in a primary care setting.
        Pain. 2000; 88: 145-153
        • Murray J.S.
        Methodological triangulation in a study of social support for siblings of children with cancer.
        Journal of Pediatric Oncology Nursing. 1999; 16: 194-200
        • Ogan M.
        • Krismer M.
        • Sollner W.
        • Kantner-Rumpmair W.
        • Lampe A.
        Chronic low back pain measurement with visual analogue scales in different settings.
        Pain. 1996; 64: 425-428
        • Perry C.L.
        • Klepp K.I.
        • Halper A.
        • Hawkins K.G.
        • Murray D.M.
        A process evaluation study of peer leaders in health education.
        Journal of School Health. 1986; 56: 62-67
        • Pillemer K.
        • Landreneau L.T.
        • Suitor J.J.
        Volunteers in a peer support project for caregivers: What motivates them?.
        American Journal of Alzheimer's Disease, Sept/Oct. 1996; : 13-19
        • Pollard C.A.
        Preliminary validity study of the Pain Disability Index.
        Perceptual and Motor Skills. 1984; 59: 974
        • Price D.D.
        • McGrath P.A.
        • Rafii A.
        • Buckingham B.
        The validation of visual analogue scales as ratio scale measures for chronic and experimental pain.
        Pain. 1983; 17: 45-56
        • Radloff L.S.
        The CES-D Scale: A self-report depression scale for research in the general population.
        Applied Psychological Measurement. 1977; 1: 385-401
        • Radloff L.S.
        • Teri L.
        Use of the Center of Epidemiological Studies–Depression Scale with older adults.
        Clinical Gerontologist. 1986; 5: 119-134
        • Reeder G.D.
        • Pryor J.B.
        • Harsh L.
        Activity and similarity on safe sex workshops led by peer educators.
        AIDS Education Preview. 1997; 9: 77-89
        • Robinson E.
        • Rankin S.H.
        • Arnstein P.
        • Carroll D.
        • Traynor K.
        Meeting the needs of unpartnered elders: A peer training program involving elders with myocardial infarction.
        Progress in Cardiovascular Nursing, Fall. 1998; : 13-23
        • Rose M.A.
        Evaluation of a peer-education program on heart disease prevention with older adults.
        Public Health Nursing. 1992; 9: 242-247
        • Sandelowski M.
        Qualitative analysis: what it is and how to begin.
        Research in Nursing and Health. 1995; 18: 371-375
        • Sandstrom K.L.
        Searching for information, understanding, and self-value: the utilization of peer support groups by gay men with HIV/AIDS.
        Social Work in Health Care. 1996; 23: 51-74
        • Serlin R.C.
        • Mendoza T.R.
        • Nakamura Y.
        • Edwards K.R.
        • Cleeland C.S.
        When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function.
        Pain. 1995; 61: 277-284
        • Sloane B.C.
        • Zimmer C.G.
        The power of peer health education.
        Journal of American College Health. 1993; 41: 241-245
        • Spector T.D.
        Epidemiology of rheumatic diseases.
        Current Opinion in Rheumatology. 1993; 5: 132-137
        • Stetz K.M.
        The relationship among background characteristics, purpose in life, and caregiving demands on perceived health of spouse caregivers.
        Scholarly Inquiry for Nursing Practice. 1989; 3: 133-153
        • Stone M.L.
        • Waters E.
        Accentuate the positive.
        Journal of Specialists in Group Work. 1991; 16: 159-166
        • Toomey T.C.
        • Taylor A.G.
        • Skelton J.A.
        • Carron H.
        Stability of self-report measures of improvement in chronic pain: A five-year follow-up.
        Pain. 1982; 12: 273-283
        • Turk D.C.
        • Okifuji A.
        Detecting depression in chronic pain patients: Adequacy of self-reports.
        Behavioral Research and Therapy. 1994; 32: 9-16
        • Turner J.A.
        • Clancy S.
        Comparison of operant behavioral and cognitive behavioral group treatment for chronic low-back pain.
        Journal of Consulting and Clinical Psychology. 1988; 56: 573-579
        • Turner J.A.
        • Jensen M.P.
        Efficacy of cognitive therapy for chronic low-back pain.
        Pain. 1993; 52: 169-177
        • U.S. Bureau of Census
        Statistical abstract of the United States: 1996.
        116th ed. .: U.S. Department of Commerce, Government Printing Office, Washington, D.C1996
        • Vlaeyen J.W.
        • Teeken-Gruben N.J.
        • Goossens M.E.
        Cognitive-educational treatment of fibromyalgia: A randomized clinical trial. I. Clinical Effects.
        Journal of Rheumatology. 1996; 23: 1237-1245
        • Weissman M.M.
        • Sholomskas D.
        • Pottenger M
        • Prusoff B.A.
        • Locke B.Z.
        Assessing depressive symptoms in five psychiatric populations: A validation study.
        American Journal of Epidemiology. 1977; 106: 203-214
        • Wewers M.E.
        • Lowe N.K.
        A critical review of Visual Analogue Scales in the measurement of clinical phenomenon.
        Research in Nursing and Health. 1990; 13: 227-236
        • Wheeler R.J.
        • Frank M.A.
        Identification of stress buffers.
        Behavioral Medicine. 1988; 14: 78-89
        • Wright G.E.
        • Parker J.C.
        • Smart K.L.
        • Schoenfeld-Smith K.
        • Buckelew S.P.
        • Slaughter J.R.
        • Johnson J.C.
        • Hewett J.E.
        Risk factors for depression in rheumatoid arthritis.
        Arthritis Care and Research. 1996; 9: 264-272
        • Wright B.
        Back pain. Patient handling—let's get it right!.
        Nursing Standard. 1992; 6: 52-53