VA Connecticut Healthcare System, Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, 950 Campbell Avenue (11 ACSLG), West Haven, CT, 06516, USA.
Yale School of Medicine, New Haven, CT, USA.
J Behav Med. 2018 Apr;41(2):174-185. doi: 10.1007/s10865-017-9885-4. Epub 2017 Sep 21.
Patient-generated treatment goals describe what patients value, yet the content of these goals, and the relationship among goal types, goal accomplishment, and treatment outcomes has received little examination. We used inductive sorting to categorize patient-generated goals made by 147 adults receiving cognitive-behavioral therapy for chronic pain. The resulting goal categories were: Physical Activity (29.0%), Functional Status (24.6%), Wellness (16.3%), Recreational Activities (11.3%), House/Yard Work (9.7%), Socializing (7.1%), and Work/School (2.0%). Next, we examined associations between number of goals by category, goal accomplishment, and clinically meaningful improvements in pain-related interference, pain intensity and depressive symptoms. Improvement in all outcome domains was related to goal accomplishment. Additionally, depressive symptoms were related to number of Physical Activity, House/Yard Work, Recreational Activities, and Wellness goals, whereas improved pain-intensity was significantly related to House/Yard Work. Classifying patient-generated goals facilitates investigation of the relationships among goal type, goal accomplishment and treatment outcomes.
患者生成的治疗目标描述了患者的价值观，但这些目标的内容以及目标类型、目标实现与治疗结果之间的关系尚未得到充分研究。我们采用归纳分类法，对 147 名接受认知行为疗法治疗慢性疼痛的成年人提出的患者生成的目标进行了分类。得到的目标类别包括：身体活动（29.0%）、功能状态（24.6%）、健康（16.3%）、娱乐活动（11.3%）、家务/庭院工作（9.7%）、社交（7.1%）和工作/学业（2.0%）。接下来，我们研究了目标类别数量、目标实现与疼痛相关干扰、疼痛强度和抑郁症状的临床显著改善之间的关系。所有结果领域的改善都与目标实现有关。此外，抑郁症状与身体活动、家务/庭院工作、娱乐活动和健康目标的数量有关，而疼痛强度的改善与家务/庭院工作显著相关。对患者生成的目标进行分类有助于研究目标类型、目标实现与治疗结果之间的关系。
