Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, NY 11794-8790, USA.
Clin J Pain. 2011 May;27(4):315-22. doi: 10.1097/AJP.0b013e3182048549.
This study examined predictors of treatment expectation among osteoarthritis (OA) patients in a multisite clinical trial of pain coping skills training (CST).
Patients (N=171) completed a pretreatment assessment battery that asked questions about treatment expectations, pain coping variables, pain, physical function, psychological distress, quality of life, and depression as well as background demographic and medical variables.
Regression analyses indicated that several variables accounted for 21% of the variance in treatment expectations (P<0.0001). Patients who were classified as adaptive copers, reported higher self-efficacy and social interaction, had higher quality of life, and who had lower levels of affective distress and depression had more positive expectations about engaging in pain CST. Variables that were not associated with treatment expectation were level of pain and physical dysfunction, duration of disease, and disability status as well as demographic variables.
Although many OA patients will approach pain CST with positive expectations, others have lower expectations. This study suggests that a multidimensional assessment of OA patients with chronic pain can identify those who have higher expectations versus lower expectations. The results suggest that patients who are psychologically distressed are less optimistic about engaging in treatment and that these patients, in particular, may benefit from and need pretreatment motivational interviewing to enhance their uptake of pain coping skills.
本研究考察了在一项疼痛应对技能训练（CST）多中心临床试验中，骨关节炎（OA）患者治疗预期的预测因素。
患者（N=171）完成了一项治疗前评估问卷，其中包括对治疗预期、疼痛应对变量、疼痛、身体功能、心理困扰、生活质量和抑郁以及背景人口统计学和医学变量的问题。
回归分析表明，有几个变量可以解释治疗预期差异的 21%（P<0.0001）。被归类为适应性应对者的患者、报告具有更高自我效能和社会互动、具有更高生活质量以及具有更低情感困扰和抑郁水平的患者对参与疼痛 CST 具有更积极的预期。与治疗预期无关的变量包括疼痛程度和身体功能障碍、疾病持续时间和残疾状况以及人口统计学变量。
尽管许多 OA 患者对疼痛 CST 抱有积极的预期，但其他人的预期较低。这项研究表明，对慢性疼痛的 OA 患者进行多维评估可以识别出那些具有较高预期的患者与具有较低预期的患者。结果表明，心理困扰的患者对参与治疗的乐观程度较低，这些患者，尤其是，可能受益于和需要预先的动机性访谈，以提高他们对疼痛应对技能的接受度。
