疼痛课程：探索为脊髓损伤成人提供的互联网疼痛管理计划的可行性。
The Pain Course: exploring the feasibility of an internet-delivered pain management programme for adults with spinal cord injury.
作者信息
Dear B F, Nicholson Perry K, Siddall P, Middleton J W, Johnson J, Katte L, Monypenny F, Karin E, Gandy M, Titov N
机构信息
eCentreClinic, Department of Psychology, Macquarie University, Sydney, NSW, Australia.
Discipline of Psychological Sciences, Australia College of Applied Psychology, Sydney, NSW, 2000, Australia.
出版信息
Spinal Cord. 2018 Oct;56(10):931-939. doi: 10.1038/s41393-018-0146-3. Epub 2018 May 31.
STUDY DESIGN
Single-group feasibility clinical trial.
OBJECTIVES
This study examined the feasibility and outcomes of a modified version of a validated internet-delivered pain management programme, the Pain Course, for adults with SCI.
SETTING
Nationwide in Australia.
METHODS
Sixty-eight adults participated in the programme, which comprises five online lessons and homework tasks that are systematically released over 8 weeks. Participants were supported through the course with weekly contact from a clinical psychologist.
RESULTS
Eighty-five percent of participants provided data at post-treatment and 76% of participants completed all five lessons of the course. High levels of satisfaction were observed and relatively little clinician time (M = 93.16 min; SD = 52.76 min) was required per participant to provide the course. Preliminary evidence of clinical improvements in pain-related disability (ds ≥ 0.53.; avg. improvement ≥ 20%; Mdiff ≥ 7.77), depression (ds ≥ 0.44.; avg. improvement ≥ 24%; Mdiff ≥ 2.44), anxiety (ds ≥ 0.41.; avg. improvement ≥ 26%; Mdiff ≥ 1.8) and average pain intensity (ds ≥ 0.46.; avg. improvement ≥ 13%; Mdiff ≥ 0.71) were observed at post-treatment, which were maintained or further improved to 3-month follow-up. These improvements were reflected in overall improvements in self-reported satisfaction with life (ds ≥ 0.31; avg. improvement ≥ 25%; Mdiff ≥ 2.16) CONCLUSION: These findings highlight the potential of carefully developed internet-delivered interventions as an approach for overcoming barriers and increasing access to psychosocial care for adults with SCI.
SPONSORSHIP
iCare Lifetime Care and Support Authority and the Australian National Health and Medical Research Council.
研究设计
单组可行性临床试验。
目的
本研究考察了一种经过验证的、通过互联网提供的疼痛管理项目（疼痛课程）的改良版对脊髓损伤成人患者的可行性和效果。
地点
澳大利亚全国范围。
方法
68名成年人参与了该项目，该项目包括5节在线课程和作业任务，在8周内系统发布。在整个课程中，临床心理学家每周与参与者联系以提供支持。
结果
85%的参与者在治疗后提供了数据，76%的参与者完成了该课程的全部5节课程。观察到参与者满意度较高，为每位参与者提供该课程所需的临床医生时间相对较少（M = 93.16分钟；标准差 = 52.76分钟）。在治疗后观察到疼痛相关残疾（效应量ds≥0.53；平均改善≥20%；平均差异Mdiff≥7.77）、抑郁（ds≥0.44；平均改善≥24%；Mdiff≥2.44）、焦虑（ds≥0.41；平均改善≥26%；Mdiff≥1.8）和平均疼痛强度（ds≥0.46；平均改善≥13%；Mdiff≥0.71）有临床改善的初步证据，这些改善在3个月随访时得以维持或进一步改善。这些改善反映在自我报告的生活满意度总体提高上（ds≥0.31；平均改善≥25%；Mdiff≥2.16）。结论：这些发现凸显了精心开发的互联网干预措施作为一种克服障碍、增加脊髓损伤成人获得心理社会护理机会的方法的潜力。
资助
iCare终身护理与支持管理局和澳大利亚国家卫生与医学研究委员会。
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