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针对复杂慢性病的认知行为疗法疼痛自我管理门诊项目十年成果。

Results from 10 Years of a CBT Pain Self-Management Outpatient Program for Complex Chronic Conditions.

作者信息

Boschen Kathryn A, Robinson Edward, Campbell Kent A, Muir Sarah, Oey Elvina, Janes Kristen, Fashler Samantha R, Katz Joel

机构信息

Bridgepoint Health, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.

University of Toronto, Toronto, ON, Canada.

出版信息

Pain Res Manag. 2016;2016:4678083. doi: 10.1155/2016/4678083. Epub 2016 Nov 6.

Abstract

Traditional unimodal interventions may be insufficient for treating complex pain, as they do not address cognitive and behavioural contributors to pain. Cognitive Behavioural Therapy (CBT) and physical exercise (PE) are empirically supported treatments that can reduce pain and improve quality of life. To examine the outcomes of a pain self-management outpatient program based on CBT and PE at a rehabilitation hospital in Toronto, Ontario. The pain management group (PMG) consisted of 20 sessions over 10 weeks. The intervention consisted of four components: education, cognitive behavioural skills, exercise, and self-management strategies. Outcome measures included the sensory, affective, and intensity of pain experience, depression, anxiety, pain disability, active and passive coping style, and general health functioning. From 2002 to 2011, 36 PMGs were run. In total, 311 patients entered the program and 214 completed it. Paired -tests showed significant pre- to posttreatment improvements in all outcomes measured. Patient outcomes did not differ according to the number or type of diagnoses. Both before and after treatment, women reported more active coping than men. The PMGs improved pain self-management for patients with complex pain. Future research should use a randomized controlled design to better understand the outcomes of PMGs.

摘要

传统的单一模式干预可能不足以治疗复杂疼痛,因为它们没有解决疼痛的认知和行为影响因素。认知行为疗法(CBT)和体育锻炼(PE)是经实证支持的治疗方法,可减轻疼痛并改善生活质量。为了研究安大略省多伦多一家康复医院基于CBT和PE的疼痛自我管理门诊项目的效果。疼痛管理组(PMG)在10周内进行了20次治疗。干预包括四个部分:教育、认知行为技能、锻炼和自我管理策略。结果测量包括疼痛体验的感觉、情感和强度、抑郁、焦虑、疼痛残疾、主动和被动应对方式以及总体健康功能。从2002年到2011年,共开展了36个PMG项目。总共有311名患者进入该项目,214名患者完成了项目。配对检验显示,所有测量结果在治疗前到治疗后均有显著改善。患者的结果不因诊断的数量或类型而有所不同。治疗前后,女性报告的主动应对方式都比男性更多。PMG项目改善了复杂疼痛患者的疼痛自我管理能力。未来的研究应采用随机对照设计,以更好地了解PMG项目的效果。

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