Basic HTML Version
210
MARK P. JENSEN ET AL.
comfortable, all you have to do is take a very deep, very satisfying breath
and hold it . . . hold it . . . and then, as you let it all the way out, let your
eyelids close and focus on your breathing. Breathe comfort in and ten-
sion out, with each breath you take. When you do this, your mind will
automatically select one or more of the skills you are learning, and you
will be able to experience the benefits of these again. . . . And the benefits
will stay with you. You may choose to practice for a minute or two every
hour, or for several minutes just a few times a day. I don’t know how
you will choose to do it, but the more you practice, the better you will
feel, and the more your mind will be able to use these skills, automati-
cally, throughout the day, so that you can feel more and more
comfortable. . . . When you need to end the experience, you’ll find that
you’re sitting up automatically, your eyes are open, your mind is clear
and alert . . . yet the comfort remains with you. No matter how clear and
alert your mind remains, this inner comfort, this inner sense of ease, can
remain with you and grow. . . . The more you practice this, the easier it
will be to keep the comfort with you. In a moment I am going to count
from ten back to one, and as I do, come back up with me, feeling more
and more aware and alert. When I reach the number “one” you will be
fully alert but still comfortable. The feelings of comfort, relaxation, and
calmness you have been feeling, these feelings will stay and linger. And
the more your practice, the better you will be at allowing yourself to feel
comfortable, until this becomes automatic.
Measures and Assessment Procedures
Outcome measures.
The primary outcome measure of this study was
average pain intensity. To assess average pain intensity at prebaseline,
participants were contacted for four telephone interviews during the 7
days immediately after study recruitment by a research assistant (not
the participant’s clinician) and asked to rate their average pain inten-
sity over the past 24 hours on a 0-to-10 numerical rating scale (NRS),
with 0 =
no pain sensation
and 10 =
the most intense pain sensation imagin-
able
. Self-report of pain intensity is now recognized by experts as the
most appropriate primary-outcome measure in most analgesic clinical
trials (Turk et al., 2003), and the 0 to 10 NRS has been recommended
as a useful measure of this pain domain because of (a) the strong evi-
dence for its validity as evidenced by its strong association with other
measures of pain intensity and responsivity to analgesic treatment, (b)
understandability and ease of use, and (c) ease of administration and
scoring (Jensen & Karoly, 2001). The four ratings of 24-hour average
pain obtained during the 7-day assessment window were combined into
a single overall composite measure of average pain. If a participant
could not be contacted four times within a 7-day period by the research
assistant, the composite score was made up of an average of the 24-hour
ratings that could be obtained during the assessment window.
The initial baseline period lasted from 2 to 27 weeks. In the 1-week
interval just before treatment, a second (postbaseline/pretreatment)