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预防慢性背痛:对一项针对亚急性背痛患者的基于理论的认知行为训练计划的评估

Preventing chronic back pain: evaluation of a theory-based cognitive-behavioural training programme for patients with subacute back pain.

作者信息

Göhner Wiebke, Schlicht Wolfgang

机构信息

University of Freiburg, Department of Sport and Sport Sciences, Schwarzwaldstr. 175, 79117 Freiburg, Germany.

出版信息

Patient Educ Couns. 2006 Dec;64(1-3):87-95. doi: 10.1016/j.pec.2005.11.018. Epub 2006 Mar 15.

Abstract

OBJECTIVE

For long-term treatment effects, patients with subacute back pain need to adhere to treatment recommendations beyond the prescribed exercise treatment. Adherence rates are as low as 30%, so we developed a cognitive-behavioural training programme to enhance patients' self-efficacy, maximise severity perceptions and reduce barrier perceptions.

METHOD

A 2 x 4 (group x time) repeated measurement design was applied. Forty-seven patients with non-specific, subacute back pain were randomly assigned to a training group (exercise treatment plus cognitive-behavioural training programme) or a control group (exercise treatment only).

RESULTS

Repeated measures ANOVA revealed significant main and interaction effects; the training group reported enhanced self-efficacy and severity perceptions, reduced barrier perceptions, and self-reported that they exercised more often than the control group over time. However, no group differences regarding pain intensity emerged.

CONCLUSION

Our findings demonstrate that a short and inexpensive cognitive-behavioural training programme is an effective tool to enable back pain patients to follow treatment recommendations on a regular basis.

PRACTICE IMPLICATIONS

The short and simple intervention can easily be conducted by personnel, other than psychologists, i.e., physiotherapists.

摘要

目的

为了获得长期治疗效果,亚急性背痛患者需要遵循规定的运动治疗以外的治疗建议。依从率低至30%,因此我们制定了一项认知行为训练计划,以提高患者的自我效能感,最大化对病情严重程度的认知,并减少对障碍的认知。

方法

采用2×4(组×时间)重复测量设计。47例非特异性亚急性背痛患者被随机分为训练组(运动治疗加认知行为训练计划)或对照组(仅运动治疗)。

结果

重复测量方差分析显示出显著的主效应和交互效应;训练组报告自我效能感增强、对病情严重程度的认知提高、对障碍的认知减少,并且自我报告随着时间推移他们比对照组更频繁地进行锻炼。然而,在疼痛强度方面未出现组间差异。

结论

我们的研究结果表明,一个简短且成本低廉的认知行为训练计划是使背痛患者能够定期遵循治疗建议的有效工具。

实践意义

这种简短且简单的干预可以由除心理学家之外的人员,即物理治疗师轻松实施。

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