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Complex regional pain syndrome: Facilitating the use of self-management strategies
Xuan Chi Julia Dao1, Rosalie Blais-Hébert1, Léonie Duranleau2, Marie-Pier Durivage2, June Litowski3, Julie Turbide4, André E Bussières5
1M.Sc.A. (Occupational Therapy), Professional Master’s, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
2M.Sc.A. (Physical Therapy), Professional Master’s, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
3B.Sc. A (Occupational Therapist), Clinical Coordinator, Neuro-musculo-skeletal Program and Evaluation and Orientation to Work Program, Constance Lethbridge Rehabilitation Centre, Montreal, Quebec, Canada
4MA (Candidate), Psycholinguistics and Cognition Lab Concordia University, Montreal, Quebec, Canada
5DC, PhD, Assistant Professor, School of Physical and Occupational Therapy, McGill University; Professor, Département Chiropratique, Université du Québec à Trois-Rivières; Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, Quebec, Canada

Article ID: 100030D05XD2017
doi:10.5348/D05-2017-30-OA-6

Address correspondence to:
André E. Bussières
School of Physical and Occupational Therapy,
Faculty of Medicine McGill University
3630 Promenade Sir-William-Osler, Montreal
Quebec, Canada

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How to cite this article:
Dao XCJ, Blais-Hébert R, Duranleau L, Marie-Pier D, Litowski J, Turbide J, Bussières AE. Complex regional pain syndrome: Facilitating the use of self-management strategies. Edorium J Disabil Rehabil 2017;3:46–55.


SUPPLEMENTARY MATERIAL 1: INTERVIEW TOPIC GUIDE

Barriers and facilitators to adherence of SMS among patients with complex regional pain syndrome - Interview topic guide

A. Opening dialogue

Hi, my name is ____________. I’m a Master’s Student at McGill University in _________.
I will be conducting the interview, while my colleague, ______, will be taking notes. Thank you for participating in our research. This interview will help us determine barriers and facilitators that impact your ability to self-manage your condition. SMS are ways to control the symptoms on your own. Strategies can include scheduling, taking frequent breaks, doing your home exercises, exercising regularly etc. Do you have any questions at this point?
Throughout the interview I will be asking a series of questions. At any time during the interview you can decide not to answer a question or you may choose to end the interview. Furthermore, to keep within the given timeframe I may stop you from further answering a question if I find that you have already addressed the question at hand.
We will start the interview by gathering some basic background information.

B. Demographic questions

Please answer the following questions:

  • When were you diagnosed with complex regional pain syndrome or CRPS?
  • °    Do you still have CRPS? How long did it last?
  • What is your date of birth (day, month, year)?
  • What is your educational level?
  • What is your occupation and are you currently working?

C. Interview topic guide

Knowledge

  • What do you understand about your condition? Do you feel you know enough?
  • What did you learn from your health care professionals in terms of your condition, diagnosis and treatment?
  • How was this information transmitted to you?
  • °  Prompts: Examples of approaches are open discussions, pamphlets, powerpoint presentations, videos, website, books, or a referral to a support group, etc.

Skills

  • What competences did you learn/use during therapy?
  • °  Prompt: Think about a problematic situation related to your condition and what were the competences that you used to overcome it?
  • How were you able to apply them at home?
  • °  Prompt: What impede from doing it?

Beliefs about capabilities

  • How confident are you in using the competences you mentioned to manage your symptoms?
  • How confident are you in applying the information provided in the educational tools to manage your symptoms?

Beliefs about consequences and reinforcement

  • Based on your opinion, what are the benefits of adhering to SMS?
  • °  Prompt: Does adhering to SMS help meet your personal goals?
  • Based on your opinion, what are the disadvantages of adhering to SMS?
  • °  Prompt: How does your self-management strategy impede your life?

Intention, goals and optimism

  • What are your goals regarding your rehabilitation process?
  • What do you use to motivate yourself to pursuit your goals?
  • °  Prompt: What helps you comply with recommended care?
  • BWhat factors impede your motivation in pursuing your goals?
  • °  Prompt: Were there any obstacles in pursuing your goals?

Memory, attention and decision processes

  • How involved were you in the decision-making process regarding your treatment options?
  • How do you feel about the involvement process in your care? How does it affect your compliance to treatments?

Environmental context and resources

  • Tell me about the physical aspects in your environment that facilitate and/or impede your ability to apply SMS (e.g., mirror therapy, motor imagery, breathing techniques, etc.)?
  • °  Prompt: Tell me about your home/work environment? Are those appropriate or not to apply your SMS?
  • Did your health care professionals provide any educational tools?
  • (i.e. These are sources of information such as pamphlets, PowerPoint presentations, open discussions, videos, websites, books, etc. about your condition)
  • °  If yes, can you name them?
  • What characteristics did you like about those?
  • Prompts: Tell me about the content, format, easiness to read/watch, understandability, layout of information/duration, use of visual aids, portability, etc.
  • What characteristics did you dislike about those?
  • Are you referring to them? How often?
  • Which one was the most useful?
  • Would you have any suggestions to improve education tools in general?
  • °  If no, would you think it would have been beneficial to have some?
  • What characteristics would you have liked?
  • Prompts: Describe to me the characteristics you want in an educational tool in terms of content, format, easiness to read/watch, understandability, layout of information/duration, use of visual aids, portability, etc.

Social influence

  • Tell me about health care professionals’ perception of your condition?
  • Tell me about family and friends’ perception of your condition?
  • Tell me about colleagues and employer’s perception of your condition?
  • How does the perception of others affect your adherence to SMS?

Emotion

  • How do you feel about your condition at this time? Can you name the emotions?
  • or

  • How did you feel about your condition when you had symptoms? Can you name the emotions?
  • Did you have the opportunity to discuss those feelings with your health care professionals?

Behavioral regulation

  • Were you given any home exercises? Can you name them?
  • How did you integrate the home exercises in your life?
  •   Prompt: What strategies helped you adhere to your treatments?
  • Do you feel you apply the SMS as much as you should? Why?

This is the end of the interview. Are there any questions you want to reflect back on? Do you have any questions? Thank you for your time and participation.



Supplementary Material 2: Elicited beliefs within TDF domains

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Supplementery 2: 1Specific beliefs were chosen according to: (a) relatively high frequency of specific beliefs, (b) presence of conflicting beliefs, and (c) evidence of strong beliefs that may impact on the behaviour


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Supplementery 2a:


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Supplementery 2b:



Supplementary Material 3: Intervention Function Definition

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Supplementery 3:




Supplementary Material 4: Behavior Change Technique definitions

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Supplementery 4:



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Acknowledgements
We wish to thank Heather Owens for reviewing the final draft of the manuscript.

Author Contributions
Xuan Chi Julia Dao – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rosalie Blais-Hébert – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Léonie Duranleau – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Marie-Pier Durivage – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
June Litowski – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Julie Turbide – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
André E. Bussières – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Conflict of interest
This study has been partially funded through the Faculty of Medicine, McGill University. At the time of this study, André Bussières was supported by a Canadian Chiropractic Research Foundation (CCRF) professorship in Epidemiology Rehabilitation at McGill University.
Copyright
© 2017 Xuan Chi Julia Dao et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.