Li Yajie, Tse Mun Yee Mimi
School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
J Med Internet Res. 2020 Jan 14;22(1):e15071. doi: 10.2196/15071.
Pain is a common public health concern, and the pain situation among the general population is serious in mainland China. Working adults commonly experience pain because of long sitting times, a lack of free time, and exercise. A lack of pain-related knowledge is also a significant factor. Educational and therapeutic programs delivered online were used more often in Western countries, and accessible programs in China are limited, especially for pain management. Therefore, we carried out an online pain education program for working adults to self-manage pain. The program was delivered through WeChat, a popular and secure social media with a large population base in China.
This study aimed to (1) provide pain-related knowledge and self-relief strategies, (2) help participants reduce pain and improve pain-related emotional well-being, and (3) explore participants' learning performance and the acceptability of the online pain education program.
This was a randomized controlled trial. Chinese adults aged between 16 and 60 years with full-time employment, with pain in the past 6 months, and without any mental illness were recruited using snowball sampling through the internet and were randomly allocated to an experimental group and a control group in 1:1 ratio after the baseline assessment. The 4-week educational program that included basic knowledge of pain, pharmacological and nonpharmacological treatments, and related resources was provided only to the experimental group. Outcomes of pain, depression, anxiety, stress, and pain self-efficacy were measured at baseline (T0), posttreatment (T1), and 1-month follow-up (T2). Participants' acceptability and satisfaction were explored after completing the educational program.
In total, 95 eligible participants joined in the program: 47 in the experimental group and 48 in the control group. Neck and shoulder, head, and back were most commonly reported pain sites with high pain scores. Pain intensity and interference of the experimental group were significantly reduced after the educational program. Depression, anxiety, and stress clinically improved and pain self-efficacy improved after the educational program. The difference in depression, anxiety, stress, and pain self-efficacy within a group or between groups was not statistically significant; however, clinical improvements were demonstrated. A significant correlation between dosage of the intervention and pain intensity and depression was demonstrated. After completing the educational program, more than half of the participants showed acceptance of and satisfaction with the program, and they were willing to recommend the program to others.
Our findings highlight the significant potential of this online education program in the treatment of pain.
ClinicalTrials.gov NCT03952910; https://clinicaltrials.gov/ct2/show/NCT03952910.
疼痛是一个常见的公共卫生问题，中国大陆普通人群的疼痛状况较为严重。在职成年人常因久坐、缺乏空闲时间和运动而经历疼痛。缺乏疼痛相关知识也是一个重要因素。西方国家更常使用在线提供的教育和治疗项目，而中国可获取的此类项目有限，尤其是在疼痛管理方面。因此，我们为在职成年人开展了一个在线疼痛教育项目，以实现疼痛的自我管理。该项目通过微信进行，微信是中国一款广受欢迎且安全的社交媒体，拥有庞大的用户群体。
本研究旨在（1）提供疼痛相关知识和自我缓解策略；（2）帮助参与者减轻疼痛并改善与疼痛相关的情绪健康；（3）探索参与者的学习表现以及在线疼痛教育项目的可接受性。
这是一项随机对照试验。通过互联网采用雪球抽样法招募年龄在16至60岁之间、全职工作、在过去6个月内有疼痛且无任何精神疾病的中国成年人，在基线评估后，将他们以1:1的比例随机分配到实验组和对照组。仅向实验组提供为期4周的教育项目，内容包括疼痛的基础知识、药物和非药物治疗以及相关资源。在基线（T0）、治疗后（T1）和1个月随访（T2）时测量疼痛、抑郁、焦虑、压力和疼痛自我效能等结果。在完成教育项目后，探索参与者的可接受性和满意度。
共有95名符合条件的参与者加入该项目：实验组47名，对照组48名。颈部和肩部、头部以及背部是最常报告的疼痛部位，疼痛评分较高。教育项目实施后，实验组的疼痛强度和干扰显著降低。教育项目实施后，抑郁、焦虑和压力在临床上有所改善，疼痛自我效能也有所提高。组内或组间抑郁、焦虑、压力和疼痛自我效能的差异无统计学意义；然而，显示出了临床改善。干预剂量与疼痛强度和抑郁之间存在显著相关性。完成教育项目后，超过一半的参与者对该项目表示接受和满意，并愿意向他人推荐该项目。
我们的研究结果突出了这个在线教育项目在疼痛治疗方面的巨大潜力。
ClinicalTrials.gov NCT03952910；https://clinicaltrials.gov/ct2/show/NCT03952910 。
