Department of Psychology, University of New Mexico, Albuquerque, New Mexico; IMPACT Community PainService, Haywood Hospital, Burslem, Stoke-on-Trent, United Kingdom.
Department of Psychology, University of New Mexico, Albuquerque, New Mexico.
J Pain. 2014 Jan;15(1):101-13. doi: 10.1016/j.jpain.2013.10.002. Epub 2013 Oct 17.
There is an emerging body of evidence regarding interdisciplinary acceptance and commitment therapy in the rehabilitative treatment of chronic pain. This study evaluated the reliability and clinical significance of change following an open trial that was briefer than that examined in previous work. In addition, the possible mediating effect of psychological flexibility, which is theorized to underlie the acceptance and commitment therapy model, was examined. Participants included 117 completers of an interdisciplinary program of rehabilitation for chronic pain. Assessment took place at treatment onset and conclusion, and at a 3-month follow-up when 78 patients (66.7%) provided data. At the 3-month follow-up, 46.2% of patients achieved clinically significant change, and 58.9% achieved reliable change, in at least 1 key measure of functioning (depression, pain anxiety, and disability). Changes in measures of psychological flexibility significantly mediated changes in disability, depression, pain-related anxiety, number of medical visits, and the number of classes of prescribed analgesics. These results add to the growing body of evidence supporting interdisciplinary acceptance and commitment therapy for chronic pain, particularly with regard to the clinical significance of an abbreviated course of treatment. Further, improvements appear to be mediated by changes in the processes specified within the theoretical model.
Outcomes of an abbreviated interdisciplinary treatment for chronic pain based on a particular theoretical model are presented. Analyses indicated that improvements at follow-up mediated change in the theorized treatment process. Clinically significant change was indicated in just under half of participants. These data may be helpful to clinicians and researchers interested in intervention approaches and mechanisms of change.
关于跨学科接受与承诺疗法在慢性疼痛康复治疗中的应用，目前已有越来越多的证据。本研究评估了一个开放试验的可靠性和变化的临床意义，该试验比以前的研究更简短。此外，还检验了接受与承诺疗法模型所依据的心理灵活性的可能中介作用。研究对象包括 117 名慢性疼痛跨学科康复项目的完成者。评估在治疗开始和结束时进行，在 3 个月的随访时，有 78 名患者（66.7%）提供了数据。在 3 个月的随访时，46.2%的患者在至少 1 项关键功能测量（抑郁、疼痛焦虑和残疾）上达到了临床显著变化，58.9%的患者达到了可靠的变化。心理灵活性测量的变化显著中介了残疾、抑郁、与疼痛相关的焦虑、就诊次数和规定止痛药的种类的变化。这些结果为跨学科接受与承诺疗法治疗慢性疼痛提供了越来越多的证据，特别是在缩短治疗疗程的临床意义方面。此外，改善似乎是通过理论模型中指定的治疗过程的变化来介导的。
呈现了一种基于特定理论模型的慢性疼痛的跨学科简短治疗的结果。分析表明，随访时的改善介导了理论治疗过程的变化。接近一半的参与者出现了临床显著的变化。这些数据可能对有兴趣了解干预方法和变化机制的临床医生和研究人员有帮助。
