Cederbom Sara, Rydwik Elisabeth, Söderlund Anne, Denison Eva, Frändin Kerstin, von Heideken Wågert Petra
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden ; School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Vasteras, Sweden.
School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Vasteras, Sweden ; Research and Development Unit, Jakobsbergs Hospital, Stockholm County Council, Järfälla, Sweden.
Clin Interv Aging. 2014 Aug 18;9:1383-97. doi: 10.2147/CIA.S66943. eCollection 2014.
To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women.
The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance.
In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study.
Results from this study are encouraging, but the study procedure and interventions have to be refined and tested in a larger feasibility study to be able to evaluate the effects of these kinds of interventions on pain-related disability, pain-related beliefs, self-efficacy in everyday activities, and morale in the target group. Further research is also needed to refine and evaluate effects from individualized reminder routines, support to collect self-report data, safety procedures for balance training, and training of personnel to enhance self-efficacy.
身为老年女性、独居、患有慢性疼痛且依赖他人照顾，这些都是可能影响日常生活的因素。对于患有疼痛相关疾病的人而言，提高日常活动能力的一种方法是在物理治疗干预中采用个体化的综合行为医学。然而，这种干预措施对居家独居、患有慢性疼痛且依赖正规护理来管理日常生活的老年女性如何起作用尚未得到研究。本研究旨在探讨一项研究的可行性，并评估针对目标女性群体的个体化定制的物理治疗综合行为医学干预措施。
本研究为一项为期12周的随机试验，采用两组设计。主要疗效指标为与疼痛相关的残疾和士气。次要疗效指标集中在与疼痛相关的信念、运动自我效能、跌倒担忧、身体活动和身体表现。
共有23名女性同意参与本研究，16名女性完成了干预。结果表明，物理治疗干预中的行为医学是可行的。在主要疗效指标上未观察到效果。实验性干预似乎提高了身体活动水平和运动自我效能。两组中的一些参与者认为，参与研究后她们能够更好地管理自己的日常生活。
本研究结果令人鼓舞，但研究程序和干预措施必须在更大规模的可行性研究中进行完善和测试，以便能够评估这类干预措施对目标群体中与疼痛相关的残疾、与疼痛相关的信念、日常活动中的自我效能以及士气的影响。还需要进一步研究来完善和评估个体化提醒程序、收集自我报告数据的支持、平衡训练的安全程序以及提高自我效能的人员培训的效果。
