Research Unit, Hospital Galdakao-Usansolo, Bizkaia, Spain.
Clin Exp Rheumatol. 2012 Nov-Dec;30(6 Suppl 74):103-11. Epub 2012 Dec 14.
OBJECTIVES: To assess the efficacy of a 6-week interdisciplinary treatment that combines coordinated psychological, medical, educational, and physiotherapeutic components (PSYMEPHY) over time compared to standard pharmacologic care. METHODS: Randomised controlled trial with follow-up at 6 months for the PSYMEPHY and control groups and 12 months for the PSYMEPHY group. Participants were 153 outpatients with FM recruited from a hospital pain management unit. Patients randomly allocated to the control group (CG) received standard pharmacologic therapy. The experimental group (EG) received an interdisciplinary treatment (12 sessions). The main outcome was changes in quality of life, and secondary outcomes were pain, physical function, anxiety, depression, use of pain coping strategies, and satisfaction with treatment as measured by the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Coping with Chronic Pain Questionnaire, and a question regarding satisfaction with the treatment. RESULTS: Six months after the intervention, significant improvements in quality of life (p=0.04), physical function (p=0.01), and pain (p=0.03) were seen in the PSYMEPHY group (n=54) compared with controls (n=56). Patients receiving the intervention reported greater satisfaction with treatment. Twelve months after the intervention, patients in the PSYMEPHY group (n=58) maintained statistically significant improvements in quality of life, physical functioning, pain, and symptoms of anxiety and depression, and were less likely to use maladaptive passive coping strategies compared to baseline. CONCLUSIONS: An interdisciplinary treatment for FM was associated with improvements in quality of life, pain, physical function, anxiety and depression, and pain coping strategies up to 12 months after the intervention.
目的:评估一种 6 周的跨学科治疗方法的疗效,该方法结合了协调的心理、医疗、教育和物理治疗成分(PSYMEPHY),与标准药物治疗相比,随着时间的推移。
方法:随机对照试验,PSYMEPHY 和对照组随访 6 个月,PSYMEPHY 组随访 12 个月。参与者为 153 名从医院疼痛管理部门招募的 FM 门诊患者。随机分配到对照组(CG)的患者接受标准药物治疗。实验组(EG)接受跨学科治疗(12 次)。主要结局是生活质量的变化,次要结局是疼痛、身体功能、焦虑、抑郁、使用疼痛应对策略以及对治疗的满意度,使用纤维肌痛影响问卷、医院焦虑抑郁量表、慢性疼痛应对问卷和一个关于对治疗的满意度的问题来衡量。
结果:干预 6 个月后,PSYMEPHY 组(n=54)与对照组(n=56)相比,生活质量(p=0.04)、身体功能(p=0.01)和疼痛(p=0.03)均有显著改善。接受干预的患者对治疗的满意度更高。干预 12 个月后,PSYMEPHY 组(n=58)的生活质量、身体功能、疼痛以及焦虑和抑郁症状仍保持统计学显著改善,并且与基线相比,更倾向于使用适应性主动应对策略。
结论:FM 的跨学科治疗与生活质量、疼痛、身体功能、焦虑和抑郁以及疼痛应对策略的改善相关,在干预后 12 个月内仍有改善。
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