Improving body awareness has been proposed as a novel non-pharmacological approach for the treatment of pain. It has been proposed as a mechanism of action for the health benefits obtained from therapeutic approaches characterized as mind-body and/or manual therapies, such as Yoga, Tai Chi, massage, mindfulness- based therapies, and Feldenkrais. These approaches enjoy a growing popularity among patients with painful condition. The hypothesis, that improving body awareness might help patients with pain, is supported by recent neuroscientific findings and needs to be subjected to rigorous clinical research. The study of body awareness, however, has been hampered by the poor definition and ambiguity of its construct. In studies of anxiety, the term body awareness has been used to describe an exaggerated patient focus on physical symptoms and is mostly seen as maladaptive for pain. Mind-body and manual therapies claim to improve pain by enhancing a particular type of body awareness characterized by non-judgmental mindfulness and a sense of embodiment. Confusion persists as to whether the patient's attention should be distracted away from or directed towards pain. There is great need to study these approaches to the treatment of pain, but a recently completed systematic review concluded that existing instruments measuring body awareness are inappropriate or limited. We propose to develop a new body awareness instrument to better understand the complex interactions of psychological factors with pain and to develop a measurement for pain research that is needed for intervention studies of mind-body and manual therapies. We refine the body awareness construct and develop a survey instrument by the following steps: 1) focus groups with providers and patients of above therapeutic approaches;2) qualitative methods for construct refinement and item collection;3) questionnaire assembly from item pool;4) in-depth cognitive testing;5) field testing the questionnaire in pain patients (n=250) using factor analysis for final item selection;6) examine internal consistency in data from field test, test-retest reliability in a patient sample (n=100). We test the final instrument in a separately funded trial (n = 50) and a therapeutic group (n = 50) with patients in body awareness training to collect pilot data for predictive and discriminant validity. This measurement study will develop an instrument for pain research that is needed to understand how differences in body awareness affect the trajectory of pain. It will provide new directions for pain research and may change the conventional paradigms associated with the treatment of acute and chronic pain.
Measure of Body Awareness Using qualitative and quantitative methods, this measurement study will systematically develop a multidi- mensional instrument for pain research that is needed to understand how differences in body awareness affect the course of pain and how mind-body and/or manual therapies provide benefits for patients with pain. A mul- tidisciplinary team of researchers will refine the construct of body awareness and produce and test a question- naire that will provide new directions for pain research and may change the conventional paradigms associated with the treatment of acute and chronic pain.
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