University of North Carolina School of Social Work, Chapel Hill, North Carolina, USA.
University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Pain Med. 2021 May 21;22(5):1080-1094. doi: 10.1093/pm/pnaa361.
This study evaluated the feasibility, acceptability, and potential effectiveness of a hybrid skills-based group intervention, dialectical pain management (DPM), for adults with chronic pain who are receiving long-term opioid therapy. DPM adapts dialectical behavior therapy, a rigorous psychotherapeutic approach to emotion dysregulation, to treat disorders of physiological dysregulation.
Individuals with chronic pain (N = 17) participated in one of two 8-week DPM intervention cohorts. At pre-test and post-test, participants completed quantitative self-report assessments measuring pain intensity and interference, depressive symptoms, pain acceptance, beliefs about pain medications, and global rating of change. Within 2 weeks after the intervention, participants completed qualitative interviews to assess participant satisfaction and obtain feedback about specific intervention components.
Of the 17 enrolled, 15 participants completed the group with 12 (70%) attending six or more sessions. Participants reported high satisfaction with the intervention. Preliminary findings suggested a significant increase in pain acceptance and a significant reduction in depressive symptoms. Participants also reported an improved relationship with their pain conditions and increased flexibility in responding to pain and applying coping skills. Several participants showed a reduction in opioid dosage over the course of the intervention.
Findings support that DPM is a feasible and well-received intervention for individuals with chronic pain. Additional research with a control group is needed to further determine the intervention's efficacy and impact.
本研究评估了一种基于混合技能的团体干预措施——辩证疼痛管理（DPM）对接受长期阿片类药物治疗的慢性疼痛患者的可行性、可接受性和潜在有效性。DPM 改编自辩证行为疗法，这是一种严格的情绪失调心理治疗方法，用于治疗生理失调障碍。
慢性疼痛患者（N=17）参加了两个为期 8 周的 DPM 干预组中的一组。在预测试和后测试时，参与者完成了定量自我报告评估，评估了疼痛强度和干扰、抑郁症状、疼痛接受度、对疼痛药物的信念以及总体变化评分。在干预后 2 周内，参与者完成了定性访谈，以评估参与者的满意度并获得有关特定干预组件的反馈。
在 17 名入组者中，有 15 名完成了团体干预，其中 12 名（70%）参加了 6 次或更多次课程。参与者对干预非常满意。初步结果表明，疼痛接受度显著增加，抑郁症状显著减轻。参与者还报告说，他们与疼痛状况的关系得到改善，并且在应对疼痛和应用应对技巧方面更加灵活。一些参与者在干预过程中减少了阿片类药物的剂量。
研究结果支持 DPM 是一种针对慢性疼痛患者的可行且受欢迎的干预措施。需要进行对照研究以进一步确定该干预措施的疗效和影响。
