Scott Whitney, McCracken Lance M
Health Psychology Section, Psychology Department, King's College London, London, United Kingdom; INPUT Pain Management, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom.
Health Psychology Section, Psychology Department, King's College London, London, United Kingdom; INPUT Pain Management, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom.
J Pain. 2015 Jun;16(6):518-26. doi: 10.1016/j.jpain.2015.02.007. Epub 2015 Mar 4.
The Patient Global Impression of Change (PGIC) measure has frequently been used as an indicator of meaningful change in treatments for chronic pain. However, limited research has examined the validity of PGIC items despite their wide adoption in clinical trials for pain. Additionally, research has not yet examined predictors of PGIC ratings following psychologically based treatment for pain. The purpose of the present study was to examine the validity, factor structure, and predictors of PGIC ratings following an interdisciplinary psychologically based treatment for chronic pain. Patients with chronic pain (N = 476) completed standard assessments of pain, daily functioning, and depression before and after a 4-week treatment program based on the principles of acceptance and commitment therapy. Following the program, patients rated 1 item assessing their impression of change overall and several items assessing their impression of more specific changes: physical and social functioning, work-related activities, mood, and pain. Results indicated that the global and specific impression of change items represent a single component. In the context of the acceptance and commitment therapy-based treatment studied here, overall PGIC ratings appeared to be influenced to a greater degree by patients' experienced improvements in physical activities and mood than by improvements in pain. The findings suggest that in addition to a single overall PGIC rating, domain-specific items may be relevant for some treatment trials.
This article reports on the validity and predictors of patients' impression of change ratings following interdisciplinary psychologically based treatment for pain. In addition to a single overall PGIC rating, domain-specific items may be important for clinicians and researchers to consider depending on the focus of treatment.
患者总体变化印象（PGIC）测量法经常被用作慢性疼痛治疗中有意义变化的指标。然而，尽管PGIC项目在疼痛临床试验中被广泛采用，但对其项目有效性的研究却很有限。此外，对于基于心理治疗的疼痛治疗后PGIC评分的预测因素尚未进行研究。本研究的目的是检验基于跨学科心理治疗的慢性疼痛治疗后PGIC评分的有效性、因素结构和预测因素。慢性疼痛患者（N = 476）在一个基于接受与承诺疗法原则的为期4周的治疗项目前后，完成了疼痛、日常功能和抑郁的标准评估。在该项目之后，患者对1个评估其总体变化印象的项目以及几个评估其更具体变化印象的项目进行了评分：身体和社会功能、与工作相关的活动、情绪和疼痛。结果表明，总体和特定变化印象项目代表一个单一成分。在此处研究的基于接受与承诺疗法的治疗背景下，总体PGIC评分似乎在更大程度上受到患者身体活动和情绪方面的改善影响，而非疼痛方面的改善。研究结果表明，除了单一的总体PGIC评分外，特定领域项目可能对某些治疗试验也有相关性。
本文报告了基于跨学科心理治疗的疼痛治疗后患者变化印象评分的有效性和预测因素。除了单一的总体PGIC评分外，特定领域项目可能对临床医生和研究人员根据治疗重点进行考虑很重要。
