Culturally relevant pain coping skills group intervention For chronic knee osteoarthritis pain: delphi consensus

Abstract

Knee osteoarthritis is a highly prevalent musculoskeletal condition associated with chronic pain in Sri Lanka. While biomedical procedures effectively address the biological aspects of chronic pain, there is a scarcity of interventions targeting its psychological dimensions. A culturally relevant pain-coping skills group intervention was developed to bridge this gap. The development of the intervention was informed by phase one of the more extensive study. A literature search was done on existing psychological interventions for chronic illnesses, pain, and psychological issues faced by patients with chronic pain. The study aimed to ensure culturally appropriate content by establishing the content and consensus validity of the newly developed intervention using Delphi consensus. A multidisciplinary expert panel consisting of clinical psychologists, a rheumatologist, a physiotherapist, and an occupational therapist was invited to review the developed intervention, worksheets, and homework assignments. The intervention sessions and worksheets were analysed for (1) usefulness in learning pain coping skills, (2) appropriateness for use with patients with pain, (3) cultural relevance for use in Sri Lanka, and (4) self-explanatory nature when used by physiotherapists and occupational therapists. Experts provided ratings and feedback using a 9-point Likert scale, where zero denoted complete disagreement and nine denoted complete agreement. The threshold for consensus was set at a minimum of 70% of the number of respondents with a level of agreement ≥ 6 (agree or strongly agree). Statements that reached the pre-established cutoff were included in the final recommendations, while those that fell short underwent revision. In the second Delphi round, consensus (≥70%) was achieved for all six sessions, and consensus-based validation was performed for the intervention. The experts’ feedback refined the intervention further. In conclusion, a culturally relevant psychological intervention was developed to meet the needs of individuals with chronic knee osteoarthritis pain in Sri Lanka. A randomized controlled trial will be conducted to examine the effectiveness of this newly developed intervention.