McCracken Lance M, Davies Megan, Scott Whitney, Paroli Mery, Harris Stephany, Sanderson Karen
Psychology Department, Institute of Psychiatry, King's College London, London, UK; Input Pain Management, Guy's and St Thomas NHS Foundation Trust, London, UK.
Pain Med. 2015 Mar;16(3):451-9. doi: 10.1111/pme.12623. Epub 2014 Dec 19.
At present, the potential benefits of psychologically oriented approaches to pain management for patients waiting to undergo medical interventions, such as neuromodulation, remain unclear. Therefore, this study aimed to examine the results of an interdisciplinary treatment based on principles of Acceptance and Commitment Therapy (ACT) delivered to a group of patients being considered for a neuromodulation procedure.
Participants were 86 adults with chronic pain. All were referrals to a 2-week, interdisciplinary, residential pain management course for people being considered for a later neuromodulation procedure. Patients completed standard self-report measures of outcome and treatment process at the beginning and end of the 2-week treatment. Data on progression on the neuromodulation pathway were extracted from medical records.
After the 2-week ACT-based interdisciplinary treatment, the majority of patients showed a clinically significant improvement on pain, depression, physical functioning, social functioning, and pain acceptance. Regression analyses indicated that change in pain acceptance related to improvements in depression, mental health, physical function, and social function. Results with regard to the trial of neuromodulation revealed that patients who did not proceed to the trial at their physician's request (n = 13) reported significantly worse depression and mental health, and lower levels of pain acceptance and committed action following the 2-week program compared with those who went for the trial.
People seeking medical interventions to reduce pain appear able to benefit from an interdisciplinary treatment aimed to improve daily functioning and mental health through increased psychological flexibility.
目前，对于等待接受神经调节等医学干预的患者，以心理为导向的疼痛管理方法的潜在益处仍不明确。因此，本研究旨在探讨基于接受与承诺疗法（ACT）原则的跨学科治疗对一组正在考虑接受神经调节手术的患者的治疗效果。
参与者为86名患有慢性疼痛的成年人。他们均被转介参加为期2周的跨学科住院疼痛管理课程，这些患者正考虑接受后续的神经调节手术。患者在为期2周的治疗开始和结束时完成了标准的自我报告结局和治疗过程测量。从病历中提取了神经调节途径进展的数据。
经过为期2周的基于ACT的跨学科治疗后，大多数患者在疼痛、抑郁、身体功能、社会功能和疼痛接受度方面均有临床显著改善。回归分析表明，疼痛接受度的变化与抑郁、心理健康、身体功能和社会功能的改善有关。关于神经调节试验的结果显示，那些应医生要求未进行试验的患者（n = 13）在为期2周的治疗后，与进行试验的患者相比，报告的抑郁和心理健康状况明显更差，疼痛接受度和承诺行动水平更低。
寻求医学干预以减轻疼痛的人似乎能够从旨在通过提高心理灵活性来改善日常功能和心理健康的跨学科治疗中受益。
