Evidence map›Paper›PMID 42663143›Full record

ArticleHealth promotion international2026

From treating pain to promoting health: a competency-based salutogenic framework for pain medicine education.

Cecília Daniele de Azevedo Nobre, Bruno Vítor Martins Santiago, Bruno Augusto Parada, Carlos Alves Darcy Bersot, Lara Calainho de Oliveira, João Vítor de Araujo Gonçalves, Liszt Palmeira de Oliveira, Hazem A Ashmawi

Abstract read
In one paragraph

Article in Health promotion international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Cecília Daniele de Azevedo NobreDepartment of Physical Medicine and Rehabilitation, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil.
Bruno Vítor Martins SantiagoDepartment of Anesthesiology, Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil.ORCID 0000-0002-2712-6311
Bruno Augusto ParadaPain Clinic, Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil.
Carlos Alves Darcy BersotDepartment of Anesthesiology, Federal University of São Paulo (UNIFESP), Rua Botucatu, 740, 5th floor, Room 562, Octávio de Carvalho Building, Vila Clementino, São Paulo, SP 04023-062, Brazil.
Lara Calainho de OliveiraSchool of Medical Sciences, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil.
João Vítor de Araujo GonçalvesSchool of Medicine and Surgery, Gaffrée e Guinle University Hospital, Federal University of the State of Rio de Janeiro (UNIRIO), Rua Mariz e Barros, 775, Maracanã, Rio de Janeiro, RJ 20270-901, Brazil.
Liszt Palmeira de OliveiraDepartment of Orthopedics and Traumatology, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil.
Hazem A AshmawiDepartment of Anesthesiology, University of São Paulo (USP), Avenida Professor Lineu Prestes, 2565, Cidade Universitária, Butantã, São Paulo, SP 05508-000, Brazil.

Funding

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
6 · The paper itself

Abstract

Chronic pain is a leading cause of disability worldwide and remains a challenge for healthcare systems, medical education, and public health. Although advances in pain neuroscience and interventional therapies have improved pain management, biomedical approaches alone are insufficient to address the multidimensional nature of persistent pain or promote adaptive recovery, participation, and long-term functioning. Contemporary pain medicine therefore requires educational models integrating health promotion, resilience, relationship-centered care, and sustainable professional practice. To develop and describe a competency-based salutogenic educational framework for pain medicine integrating contemporary concepts from pain science, health promotion, behavioral science, and medical education. The framework was developed through conceptual integration of complementary theories from pain medicine, psychology, health promotion, and competency-based medical education. It combines total pain, salutogenesis and sense of coherence, resilience, Social Cognitive Theory, therapeutic alliance, and physician professional sustainability within a longitudinal educational structure. Rather than replacing existing biopsychosocial or salutogenic models, it integrates their complementary strengths by explicitly linking adaptive recovery, relationship-centered care, competency development, authentic assessment, and health promotion. Educational implications include longitudinal competency-based curricula, reflective practice, interdisciplinary learning, patient partnership, workplace-based assessment, and validated psychometric instruments alongside competency-based educational assessments to evaluate learner and patient outcomes. The proposed framework reorients pain medicine education beyond symptom management toward adaptive recovery, participation, equity, and person-centered care. By integrating health promotion with competency-based medical education, it provides a conceptual foundation for curriculum development, implementation research, and evaluation of educational strategies to improve outcomes for patients, healthcare professionals, and health systems.

Indexed as

Chronic PainCompetency-Based EducationEducation, MedicalHealth PromotionPain ManagementClinical CompetenceCurriculumHumanschronic paincompetency-based medical educationhealth promotionmedical educationpain medicineresiliencesalutogenesissense of coherencetherapeutic alliance

Identifiers

PMID42663143
PMCPMC13522839

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.