University of Sydney Pain Management and Research Centre, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
Clin J Pain. 2010 Mar-Apr;26(3):206-16. doi: 10.1097/AJP.0b013e3181bff8f3.
To evaluate the effectiveness of a specifically modified group-based, multidisciplinary cognitive-behavioral pain management program (PMP) in comparison to usual care in a clinical sample of people with spinal cord injury (SCI)-related chronic pain.
Changes over time on a range of measures, including usual pain intensity, pain catastrophizing and self-efficacy, mood, SCI acceptance and self-efficacy, and interference due to pain were examined in 2 groups with SCI-related chronic pain after a multidisciplinary pain assessment. One group (n=19) attended the PMP, and the other (n=17) received standard care on an individualized basis in a pain management center.
The groups were significantly different at baseline, with the PMP group scoring more negatively on a number of the measures, including usual pain intensity. The PMP group showed an overall improvement in mood and life interference due to pain at the end of the PMP when compared with the usual care group. Within the PMP group, there was a significant improvement over time in anxiety and pain catastrophizing. No changes in SCI-related psychologic variables (acceptance and self-efficacy) were observed in either group.
This study demonstrates that a PMP may offer benefits to clinical populations with SCI-related chronic pain in a pain management center. The reported improvements were of a magnitude to be clinically significant. However, some of the initial benefits reported were not maintained at the nine month follow-up. The interventions may need to be augmented to address the effects of SCI-related psychologic variables that may impact upon the individual's ability to benefit from a PMP.
评估专门修改的基于小组的多学科认知行为疼痛管理方案（PMP）与临床脊髓损伤（SCI）相关慢性疼痛患者的常规护理相比的有效性。
对经过多学科疼痛评估的 2 组 SCI 相关慢性疼痛患者，在一系列评估指标（包括通常的疼痛强度、疼痛灾难化和自我效能感、情绪、SCI 接受度和自我效能感以及疼痛所致干扰）上，随时间变化的情况进行了研究。一组（n=19）参加了 PMP，另一组（n=17）在疼痛管理中心接受了基于个体的标准护理。
两组在基线时存在显著差异，PMP 组在一些评估指标上的得分明显较低，包括通常的疼痛强度。与常规护理组相比，PMP 组在 PMP 结束时的情绪和疼痛所致生活干扰方面总体上有所改善。在 PMP 组中，焦虑和疼痛灾难化随时间呈现出显著的改善。在两组中，均未观察到与 SCI 相关的心理变量（接受度和自我效能感）的变化。
本研究表明，在疼痛管理中心，PMP 可能对具有 SCI 相关慢性疼痛的临床人群有益。报告的改善具有临床意义的幅度。然而，报告的一些初始益处并未在 9 个月的随访中得到维持。干预措施可能需要增强，以解决影响个体从 PMP 中获益的 SCI 相关心理变量的影响。
