The Ottawa Hospital Rehabilitation Centre, Ottawa, Ontario, Canada.
Pain Res Manag. 2011 Nov-Dec;16(6):451-6. doi: 10.1155/2011/817816.
There is good support for the effectiveness of interdisciplinary chronic pain management programs in improving functional outcomes; however, relatively little is known about patients who report deterioration following participation in such programs.
The present retrospective study investigated patients' reports of increased pain severity during participation in a cognitive-behaviourally oriented, outpatient treatment for chronic pain.
Participants (n=280) completed a four-week, group-based, interdisciplinary chronic pain self-management program at a rehabilitation hospital. They completed pre- and post-treatment questionnaires, which included global change ratings of pain severity and clinically-relevant measures, including pain intensity ratings, functional limitations, pain catastrophizing and self-efficacy.
Statistically significant pre-post improvements were observed for all study variables. Almost all patients reported global improvement overall. Nevertheless, a subset of patients (n=99) reported increased pain severity on global ratings. These individuals were characterized by lower self-efficacy at baseline.
Participants endorsed significant pre- and post-treatment improvements in all domains. Nevertheless, some participants reported deterioration. The findings shed light on variables associated with negative treatment outcomes and have practical applications for interdisciplinary chronic pain management programs.
多学科慢性疼痛管理方案在改善功能结果方面的有效性得到了很好的支持；然而，对于那些在参与此类方案后报告病情恶化的患者，我们知之甚少。
本回顾性研究调查了患者在参加认知行为导向的慢性疼痛门诊治疗期间报告疼痛严重程度增加的情况。
参与者（n=280）在一家康复医院完成了为期四周的、基于小组的、多学科慢性疼痛自我管理方案。他们在治疗前和治疗后完成了问卷，其中包括疼痛严重程度的整体变化评分和临床相关的测量，包括疼痛强度评分、功能限制、疼痛灾难化和自我效能感。
所有研究变量均观察到统计学上显著的治疗前后改善。几乎所有患者都报告了整体改善。然而，仍有一部分患者（n=99）报告了全球评分的疼痛加重。这些人在基线时的自我效能感较低。
参与者在所有领域都报告了治疗前后的显著改善。然而，一些参与者报告了病情恶化。研究结果揭示了与负面治疗结果相关的变量，并为多学科慢性疼痛管理方案提供了实际应用。
