Center on Mindfulness and Integrative Health Intervention Development (C-MIIND), University of Utah, 395 South, 1500 East, Salt Lake City, UT, 84112, USA.
Social Work Department, University of Utah Hospital, Salt Lake City, UT, USA.
J Gen Intern Med. 2017 Oct;32(10):1106-1113. doi: 10.1007/s11606-017-4116-9. Epub 2017 Jul 12.
Medical management of acute pain among hospital inpatients may be enhanced by mind-body interventions.
We hypothesized that a single, scripted session of mindfulness training focused on acceptance of pain or hypnotic suggestion focused on changing pain sensations through imagery would significantly reduce acute pain intensity and unpleasantness compared to a psychoeducation pain coping control. We also hypothesized that mindfulness and suggestion would produce significant improvements in secondary outcomes including relaxation, pleasant body sensations, anxiety, and desire for opioids, compared to the control condition.
This three-arm, parallel-group randomized controlled trial conducted at a university-based hospital examined the acute effects of 15-min psychosocial interventions (mindfulness, hypnotic suggestion, psychoeducation) on adult inpatients reporting "intolerable pain" or "inadequate pain control." Participants (N = 244) were assigned to one of three intervention conditions: mindfulness (n = 86), suggestion (n = 73), or psychoeducation (n = 85).
Participants in the mind-body interventions reported significantly lower baseline-adjusted pain intensity post-intervention than those assigned to psychoeducation (p < 0.001, percentage pain reduction: mindfulness = 23%, suggestion = 29%, education = 9%), and lower baseline-adjusted pain unpleasantness (p < 0.001). Intervention conditions differed significantly with regard to relaxation (p < 0.001), pleasurable body sensations (p = 0.001), and desire for opioids (p = 0.015), but all three interventions were associated with a significant reduction in anxiety (p < 0.001).
Brief, single-session mind-body interventions delivered by hospital social workers led to clinically significant improvements in pain and related outcomes, suggesting that such interventions may be useful adjuncts to medical pain management.
Trial Registry: ClinicalTrials.gov ; registration ID number: NCT02590029 URL: https://clinicaltrials.gov/ct2/show/NCT02590029.
医院住院患者急性疼痛的医学管理可以通过身心干预来增强。
我们假设,与心理教育疼痛应对控制相比,单次脚本的正念训练侧重于接受疼痛或通过意象专注于改变疼痛感觉的催眠暗示,将显著降低急性疼痛强度和不适。我们还假设,与对照条件相比,正念和暗示会显著改善包括放松、愉快的身体感觉、焦虑和对阿片类药物的渴望在内的次要结果。
这项在一所大学附属医院进行的三臂平行组随机对照试验,研究了 15 分钟心理社会干预(正念、催眠暗示、心理教育)对报告“无法忍受的疼痛”或“疼痛控制不足”的成年住院患者的急性影响。参与者(N=244)被分配到三个干预条件之一:正念(n=86)、暗示(n=73)或心理教育(n=85)。
与接受心理教育的参与者相比,身心干预组的参与者在干预后报告的基线调整后疼痛强度显著降低(p<0.001,疼痛减轻百分比:正念=23%,暗示=29%,教育=9%),且疼痛不适的基线调整后也显著降低(p<0.001)。在放松(p<0.001)、愉快的身体感觉(p=0.001)和对阿片类药物的渴望(p=0.015)方面,干预条件也存在显著差异,但所有三种干预都与焦虑的显著降低有关(p<0.001)。
由医院社会工作者提供的简短、单次的身心干预措施可显著改善疼痛及相关结果,表明此类干预措施可能是医学疼痛管理的有用辅助手段。
试验注册:ClinicalTrials.gov;注册号:NCT02590029;网址:https://clinicaltrials.gov/ct2/show/NCT02590029。