可穿戴式呼吸监测与反馈在儿童癌症幸存者成人慢性疼痛中的应用：来自儿童癌症幸存者研究的一项可行性随机对照试验。
Wearable Respiratory Monitoring and Feedback for Chronic Pain in Adult Survivors of Childhood Cancer: A Feasibility Randomized Controlled Trial From the Childhood Cancer Survivor Study.
机构信息
St Jude Children's Research Hospital, Memphis, TN.
Concordia University, Montréal, Quebec, Canada.
出版信息
JCO Clin Cancer Inform. 2020 Nov;4:1014-1026. doi: 10.1200/CCI.20.00070.
PURPOSE
Approximately 40% of childhood cancer survivors experience chronic pain, with many also reporting pain-related disability. Given associations established in the general population among respiration, anxiety, and pain, continuous tracking and feedback of respiration may help survivors manage pain.
METHODS
A feasibility, nonblinded, randomized controlled trial (RCT) comparing wearable respiratory monitoring with a control group examined feasibility, acceptability, and preliminary efficacy among survivors of childhood cancer with chronic pain who were ≥ 18 years of age, able to speak and read English, lived in the United States, and had access to a smartphone and the Internet. The primary outcomes were pain interference, pain severity, anxiety, negative affect, and perceived stress. The intervention group (n = 32) received a wearable respiratory monitor, used the device, and completed an in-application breathing exercise daily for 30 days. The control group (n = 33) received psychoeducation after completion of the study.
RESULTS
Almost all participants in the intervention group (n = 31 of 32) and control group (n = 32 of 33) completed the study. Of those who completed the intervention, 90.3% wore the device for ≥ 50% of the trial. Posttreatment improvement for negative affect (Cohen = 0.59; 95% CI, 0.09 to 1.10) was significantly greater in the intervention group compared with the control group. A follow-up study (n = 24) examined acceptability and feasibility of a second-generation device among those who completed the RCT. Most survivors (81.0%) wore the device daily during the trial and 85.7% reported satisfaction with the device and the application.
CONCLUSION
The results of this pilot study support the acceptability and feasibility of wearable respiratory monitoring among survivors of childhood cancer. Larger randomized trials are needed to assess efficacy and maintenance of this intervention for chronic pain.
目的
大约 40%的儿童癌症幸存者会经历慢性疼痛，其中许多人还报告存在与疼痛相关的残疾。鉴于在普通人群中已确定的呼吸、焦虑和疼痛之间的关联，对呼吸进行持续跟踪和反馈可能有助于幸存者管理疼痛。
方法
一项可行性、非盲、随机对照试验（RCT）比较了可穿戴呼吸监测与对照组，该试验纳入了≥18 岁、能够说英语和阅读英语、居住在美国、能够使用智能手机和互联网的患有慢性疼痛的儿童癌症幸存者，评估了该研究的可行性、可接受性和初步疗效。主要结局指标为疼痛干扰、疼痛严重程度、焦虑、负性情绪和感知压力。干预组（n=32）接受可穿戴呼吸监测仪，并在 30 天内每天使用该设备完成应用内呼吸练习。对照组（n=33）在研究完成后接受心理教育。
结果
干预组（n=32）和对照组（n=33）几乎所有参与者均完成了研究。在完成干预的参与者中，90.3%的人佩戴设备的时间≥试验的 50%。与对照组相比，干预组的负性情绪（Cohen d=0.59；95%CI，0.09 至 1.10）在治疗后改善更显著。一项后续研究（n=24）在完成 RCT 的参与者中评估了第二代设备的可接受性和可行性。大多数幸存者（81.0%）在试验期间每天佩戴设备，85.7%的人对设备和应用程序表示满意。
结论
这项初步研究的结果支持在儿童癌症幸存者中使用可穿戴呼吸监测的可接受性和可行性。需要更大规模的随机试验来评估该干预措施对慢性疼痛的疗效和维持情况。
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