Center for Health Equity Research and Promotion.
School of Medicine.
Pain Med. 2017 Oct 1;18(10):1908-1920. doi: 10.1093/pm/pnx141.
Osteoarthritis is a leading cause of disability for which there is no cure. Psychosocial-oriented treatments are underexplored. We developed and tested an intervention to build positive psychological skills (e.g., gratitude) to reduce osteoarthritis symptom severity, including pain and functioning, and to improve psychosocial well-being in patients with knee or hip osteoarthritis.
Two-arm randomized design with six-month follow-up.
An academic Veterans Affairs Medical Center.
Patients aged 50 years or older with knee or hip osteoarthritis and pain ratings of 4 or higher.
Patients (N = 42) were randomized to a six-week program containing positive skill-building activities or neutral control activities tailored to the patient population. Adherence was assessed by telephone each week. We assessed osteoarthritis symptom severity (WOMAC Osteoarthritis Index) and measures of well-being (positive affect, negative affect, and life satisfaction) at baseline and by telephone one, three, and six months after the program ended. We used linear mixed models to examine changes over time.
The majority (64%) of patients completed more than 80% of their weekly activities. Patients in the positive (vs neutral) program reported significantly more improvement over time in osteoarthritis symptom severity (P = 0.02, Cohen's d = 0.86), negative affect (P = 0.03, Cohen's d = 0.50), and life satisfaction (P = 0.02, Cohen's d = 0.36).
The study successfully engaged patients with knee or hip osteoarthritis in a six-week intervention to build positive psychological skills. Improving osteoarthritis symptom severity and measures of psychosocial well-being, the intervention shows promise as a tool for chronic pain management.
骨关节炎是导致残疾的主要原因之一，但目前尚无治愈方法。心理社会导向的治疗方法尚未得到充分探索。我们开发并测试了一种干预措施，以建立积极的心理技能（例如感恩），从而减轻膝关节或髋关节骨关节炎患者的关节炎症状严重程度，包括疼痛和功能，并改善其心理社会幸福感。
有六个月随访的双臂随机设计。
学术性退伍军人事务医疗中心。
年龄在 50 岁或以上、膝关节或髋关节骨关节炎且疼痛评分为 4 或更高的患者。
将 42 名患者随机分为六周的方案组，该方案组包含积极的技能建设活动或针对患者人群的中性对照活动。每周通过电话评估依从性。我们在基线时以及方案结束后一个、三个月和六个月通过电话评估关节炎症状严重程度（WOMAC 骨关节炎指数）和幸福感测量指标（积极情绪、消极情绪和生活满意度）。我们使用线性混合模型来检查随时间的变化。
大多数（64%）患者完成了每周活动的 80%以上。与中性方案相比，积极方案的患者在关节炎症状严重程度（P=0.02，Cohen's d=0.86）、消极情绪（P=0.03，Cohen's d=0.50）和生活满意度（P=0.02，Cohen's d=0.36）方面随时间的改善更为显著。
该研究成功地使膝关节或髋关节骨关节炎患者参与了六周的干预措施，以建立积极的心理技能。改善骨关节炎症状严重程度和心理社会幸福感的测量指标表明，该干预措施有望成为慢性疼痛管理的一种工具。
