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“所有这些并不能消除疼痛,但它们确实能帮助你接受它”:为基于同情的疗法在持续性疼痛管理中的应用提供依据。

'All these things don't take the pain away but they do help you to accept it': making the case for compassion-focused therapy in the management of persistent pain.

作者信息

Gooding Hannah, Stedmon Jacqui, Crix Doug

机构信息

Children's Psychological Health and Wellbeing Team, Level 12, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK.

Plymouth University, Plymouth, UK.

出版信息

Br J Pain. 2020 Feb;14(1):31-41. doi: 10.1177/2049463719857099. Epub 2019 Jun 17.

Abstract

BACKGROUND

People with persistent pain are frequently offered a pain management programme (PMP) as part of their care plan. Cognitive behavioural therapy (CBT) principles often underpin PMPs and has a good evidence base; nevertheless, more recent systematic reviews have suggested that its effectiveness is limited. Compassion-focused therapy (CFT) is a form of 'third-wave CBT' that offers an alternative and complementary view of pain, encouraging the person to be alongside their experience of pain and respond to it using skills of compassion they have learnt.

METHOD

The current research explored the effectiveness of a 12-week CFT group for people who experience persistent pain. Research interviews explored CFT members' experiences of the CFT group. Feedback was collected on the facilitators' experience of running the group and questionnaire data collected on participants' mood, pain disability, acceptance of chronic pain and levels of self-criticism and self-reassurance.

RESULTS

Interviews were analysed using interpretative phenomenological analysis that revealed five master superordinate themes representative across all interviews. These were then triangulated with data from the questionnaires and facilitator feedback.

CONCLUSION

In people whose persistent pain was compounded by a significant psychological component, a CFT group approach helped reduce feelings of isolation, improve ability to self-reassure, learn new ways of coping and develop a growing acceptance of the limitations associated with their pain. The possible implications for future clinical practice are considered.

摘要

背景

持续性疼痛患者通常会被纳入疼痛管理计划(PMP)作为其护理计划的一部分。认知行为疗法(CBT)原则常作为PMP的基础,且有充分的证据支持;然而,最近的系统评价表明其效果有限。以同情为中心的疗法(CFT)是“第三波CBT”的一种形式,它对疼痛提供了一种不同的、互补的观点,鼓励患者直面自己的疼痛体验,并运用所学的同情技巧来应对。

方法

当前研究探讨了为期12周的CFT小组对持续性疼痛患者的有效性。研究访谈探究了CFT小组成员对CFT小组的体验。收集了关于小组 facilitators 带领小组的经验的反馈,并收集了关于参与者情绪、疼痛残疾、对慢性疼痛的接受程度以及自我批评和自我安慰水平的问卷数据。

结果

使用解释性现象学分析对访谈进行分析,揭示了在所有访谈中具有代表性的五个主要上级主题。然后将这些主题与问卷数据和 facilitator 反馈的数据进行三角验证。

结论

对于持续性疼痛因显著心理因素而加剧的患者,CFT小组方法有助于减少孤独感,提高自我安慰能力,学习新的应对方式,并逐渐接受与疼痛相关的局限性。文中考虑了对未来临床实践可能产生的影响。

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