Lange M, Krohn-Grimberghe B, Petermann F
Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Grazer Str. 2 & 6, 28359, Bremen, Deutschland.
Z Rheumatol. 2011 Jun;70(4):324-31. doi: 10.1007/s00393-011-0792-8.
The efficacy of a cognitive-behavioral patient education program was compared with the efficacy of treatment based solely on patient education. Both forms of treatment were integrated into the inpatient rehabilitation program. For therapy of fibromyalgia a multimodal therapy has been shown to be effective. Stress management, pain management and relaxation techniques enhance the ability to cope with the disease.
Various questionnaires including the Hospital Anxiety and Depression Scale (HADS-D), the questionnaire for assessment of level of coping with pain (FESV) and the patient questionnaire IRES-24 were distributed to 3,541 fibromyalgia patients within the framework of a pre, post and 6-month follow-up study design. Multivariate variance models were used for data analysis.
Both interventions showed positive effects on psychological impairment, coping with pain and state of health. Only the paired comparison showed different results. However, cognitive-behavioral patient education showed better effects on independent coping with the disease. These patients showed an improved ability to cope with pain and a better state of health at the end of the rehabilitation program.
Multimodal inpatient rehabilitation programs can have a strong positive impact on the course of the disease for patients with fibromyalgia. A cognitive-behavioral treatment appears to strongly influence coping with the disease.
将认知行为患者教育项目的疗效与仅基于患者教育的治疗疗效进行比较。两种治疗形式均纳入住院康复项目。对于纤维肌痛的治疗,多模式疗法已被证明是有效的。压力管理、疼痛管理和放松技巧可增强应对该疾病的能力。
在一项前测、后测及6个月随访研究设计的框架内,向3541名纤维肌痛患者发放了各种问卷,包括医院焦虑抑郁量表(HADS-D)、疼痛应对水平评估问卷(FESV)和患者问卷IRES-24。采用多变量方差模型进行数据分析。
两种干预措施均对心理损伤、疼痛应对和健康状况产生了积极影响。仅配对比较显示出不同结果。然而,认知行为患者教育在独立应对疾病方面显示出更好的效果。这些患者在康复项目结束时表现出更好的疼痛应对能力和更健康的状态。
多模式住院康复项目对纤维肌痛患者的病程可产生强烈的积极影响。认知行为治疗似乎对疾病应对有强烈影响。