University of Stavanger, Faculty of Social Sciences, Department of Health Studies, N-4036 Stavanger, Norway.
Int J Nurs Stud. 2010 Jul;47(7):826-35. doi: 10.1016/j.ijnurstu.2009.12.001. Epub 2009 Dec 29.
Cognitive behavioural therapy (CBT) has been useful in the treatment of chronic pain conditions for many years. Given the increasing number of persons with chronic pain and associated psychosocial problems, the development and implementation of effective interventions based on CBT is warranted.
The aim of this study is to evaluate the effects of a multidisciplinary pain management programme on health-related quality of life (HRQL), as measured by the Short Form Health Survey (SF-36), pain perception as measured by the Brief Pain Inventory (BPI), and readiness-to-change as measured by the Pain Stages of Change Questionnaire (PSOCQ).
A pretest-post-test quasi-experimental design, with waiting list controls and baseline and post-test measures, was used.
The study was conducted in the rehabilitation unit of a university hospital.
Of 117 people suffering from chronic pain, 113 completed the 8-week multidisciplinary pain management programme. The patients were consecutive referrals. Inclusion criteria were: adults (18-67 years), pain lasting over 6 months, motivation and no ongoing litigation. Exclusion criteria were affected by major mental disorders or major medical conditions requiring treatment.
The intervention was based on a cognitive behavioural approach. Therapeutic dialogues and training, combined with physical activity, were provided to a fixed plan, including homework. The programme has several features that directly address psychosocial aspects of chronic pain. Statistical and clinical significance are considered.
The findings suggest that this programme has the potential to improve HRQL, reduce pain intensity and interference, and contribute to improvement in readiness-to-change. Statistically significant results are supplemented by results showing their clinical significance.
Improvements in HRQL, pain-related disability, and readiness-to-change suggest that the vicious cycle of chronic pain may be alleviated by our programme. As we see it, effective treatment results are about identifying and addressing the important and changeable influences maintaining pain problems such as acceptance, understanding the mind-body connection and self-management. Although further research is needed to evaluate the effectiveness of this work, such group approaches appear to represent a feasible treatment option for many patients with chronic pain.
认知行为疗法（CBT）多年来一直被用于治疗慢性疼痛疾病。鉴于患有慢性疼痛及相关心理社会问题的人数不断增加，有必要开发和实施基于 CBT 的有效干预措施。
本研究旨在评估多学科疼痛管理方案对健康相关生活质量（HRQL）的影响，该方案通过简明健康调查问卷（SF-36）进行评估，通过简明疼痛量表（BPI）评估疼痛感知，通过疼痛变化阶段问卷（PSOCQ）评估改变意愿。
采用预测试-后测试准实验设计，设有等待名单对照和基线及后测试测量。
研究在一所大学医院的康复病房进行。
在 117 名患有慢性疼痛的患者中，有 113 名完成了 8 周的多学科疼痛管理方案。这些患者是连续转诊而来。纳入标准为：成年人（18-67 岁），疼痛持续 6 个月以上，有动机且没有正在进行的诉讼。排除标准为患有重大精神障碍或需要治疗的重大医疗状况。
干预措施基于认知行为方法。治疗对话和培训与身体活动相结合，按照固定计划提供，包括家庭作业。该方案具有几个直接针对慢性疼痛心理社会方面的特点。考虑了统计和临床意义。
研究结果表明，该方案有可能改善 HRQL，降低疼痛强度和干扰，促进改变意愿的改善。统计显著结果辅以显示其临床意义的结果。
HRQL、疼痛相关残疾和改变意愿的改善表明，我们的方案可能缓解慢性疼痛的恶性循环。在我们看来，有效的治疗结果是确定和解决维持疼痛问题的重要和可改变的影响，例如接受、理解身心联系和自我管理。虽然需要进一步研究来评估这项工作的有效性，但这种小组方法似乎代表了许多慢性疼痛患者可行的治疗选择。
