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50 岁及以上患有慢性疼痛和精神健康合并症的成年人中,由老年同伴和临床医生共同促进的疼痛康复干预的初步结果。

Preliminary Outcomes of an Older Peer and Clinician co-Facilitated Pain Rehabilitation Intervention among Adults Aged 50 Years and Older with Comorbid Chronic Pain and Mental Health Conditions.

机构信息

Columbia University School of Nursing, 560 West 168th Street, New York, NY, 10032, USA.

Department of Rehabilitation Sciences, University of Texas at El Paso, El Paso, TX, 79902, USA.

出版信息

Psychiatr Q. 2021 Jun;92(2):561-571. doi: 10.1007/s11126-020-09831-5.

Abstract

The present study aimed to examine the acceptability, feasibility, and preliminary effectiveness of an older peer and clinician co-facilitated Behavioral Activation for Pain Rehabilitation (BA-PR) intervention among adults aged 50 years and older with comorbid chronic pain and mental health conditions. This was a mixed-methods research design with eight participants aged 55 to 62 years old with mental health conditions including schizophrenia spectrum disorder, bipolar disorder, major depressive disorder, personality disorder, and adjustment disorder. The quantitative data were assessed from observational methods, a pain rating scale and related measures. We used semi-structured interviews for qualitative feedback on experiences with the BA-PR intervention after participation. Overall, the participants had positive experiences following receipt of the BA-PR intervention. The recruitment and adherence rates for participants were 72.7% and 100%, respectively. Approximately 75% of the participants remained enrolled in the study. Findings from a paired t-test showed the BA-PR intervention was linked to significantly reduced prescription opioid misuse risk, t (7) = 2.42, p < 0.05. There were also non-significant reductions in pain intensity and depression severity, in addition to improvements in active and passive pain coping strategies and behavioral activation.The BA-PR intervention is the first pain rehabilitation intervention specifically designed for middle-aged and older adults with comorbid chronic pain and mental health conditions. Our findings indicate promise for the BA-PR intervention to potentially reduce prescription opioid misuse risk, pain, and depressive symptoms. However, a quasi-experimental study is needed before rigorous effectiveness testing.

摘要

本研究旨在考察一种由老年同伴和临床医生共同实施的行为激活疼痛康复(BA-PR)干预措施在 50 岁及以上患有共病慢性疼痛和精神健康状况的成年人中的可接受性、可行性和初步效果。这是一项混合方法研究设计,有 8 名年龄在 55 至 62 岁之间的参与者,他们患有精神健康状况,包括精神分裂症谱系障碍、双相情感障碍、重性抑郁障碍、人格障碍和适应障碍。定量数据是通过观察方法、疼痛评分量表和相关措施进行评估的。我们使用半结构化访谈获得参与者对 BA-PR 干预体验的定性反馈。总体而言,参与者在接受 BA-PR 干预后有积极的体验。参与者的招募率和依从率分别为 72.7%和 100%。大约 75%的参与者仍在参与研究。配对 t 检验的结果表明,BA-PR 干预与处方阿片类药物滥用风险显著降低有关,t(7)=2.42,p<0.05。疼痛强度和抑郁严重程度也有非显著降低,以及积极和被动的疼痛应对策略和行为激活的改善。BA-PR 干预是专为患有共病慢性疼痛和精神健康状况的中年和老年成年人设计的第一个疼痛康复干预措施。我们的研究结果表明,BA-PR 干预有可能降低处方阿片类药物滥用风险、疼痛和抑郁症状。然而,在进行严格的有效性测试之前,需要进行准实验研究。

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Trends in opioid analgesic abuse and mortality in the United States.
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