Merlin Jessica S, Young Sarah R, Johnson Mallory O, Saag Michael, Demonte William, Kerns Robert, Bair Matthew J, Kertesz Stefan, Turan Janet M, Kilgore Meredith, Clay Olivio J, Pekmezi Dorothy, Davies Susan
Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, United States.
Contemp Clin Trials Commun. 2018 Feb 19;10:9-16. doi: 10.1016/j.conctc.2018.02.004. eCollection 2018 Jun.
Chronic pain is an important comorbidity among individuals with HIV. Behavioral interventions are widely regarded as evidence-based, efficacious non-pharmacologic interventions for chronic pain in the general population. An accepted principle in behavioral science is that theory-based, systematically-developed behavioral interventions tailored to the unique needs of a target population are most likely to be efficacious. Our aim was to use Intervention Mapping to systematically develop a Social Cognitive Theory (SCT)-based intervention for chronic pain tailored to individuals with HIV that will improve pain intensity and pain-related functional impairment. Our Intervention Mapping process was informed by qualitative inquiry of 24 patients and seven providers in an HIV primary care clinic. The resulting intervention includes group and one-on-one sessions and peer and staff interventionists. We also developed a conceptual framework that integrates our qualitative findings with SCT-based theoretical constructs. Using this conceptual framework as a guide, our future work will investigate the intervention's impact on chronic pain outcomes, as well as our hypothesized proximal mediators of the intervention's effect.
慢性疼痛是艾滋病毒感染者中一种重要的合并症。行为干预被广泛认为是针对普通人群慢性疼痛的循证、有效的非药物干预措施。行为科学中一个公认的原则是,基于理论、系统开发的针对目标人群独特需求的行为干预措施最有可能有效。我们的目标是使用干预映射法,系统地开发一种基于社会认知理论(SCT)的针对艾滋病毒感染者慢性疼痛的干预措施,以改善疼痛强度和与疼痛相关的功能损害。我们的干预映射过程是通过对一家艾滋病毒初级保健诊所的24名患者和7名医护人员进行定性调查得出的。最终的干预措施包括小组和一对一辅导课程,以及同伴和工作人员干预者。我们还开发了一个概念框架,将我们的定性研究结果与基于SCT的理论结构相结合。以这个概念框架为指导,我们未来的工作将研究该干预措施对慢性疼痛结果的影响,以及我们假设的该干预措施效果的近端中介因素。