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一项跨学科慢性盆腔疼痛项目的开展与疗效

The development and efficacy of an interdisciplinary chronic pelvic pain program.

作者信息

Katz Laura, Fransson Adria, Patterson Lisa

机构信息

Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, McMaster University Medical Centre, Hamilton, ON, Canada.

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.

出版信息

Can Urol Assoc J. 2021 Jun;15(6):E323-E328. doi: 10.5489/cuaj.6842.

Abstract

INTRODUCTION

Chronic pelvic pain (CPP) is a significant issue, and approximately 14% of women experience CPP once in their life-time. While interdisciplinary pain management is considered the gold standard of treatment, few programs offer this type of treatment in Canada. The aims of this paper were to: 1) describe the development of an interdisciplinary CPP program; and 2) demonstrate changes in patient-related outcomes after attending an interdisciplinary CPP program.

METHODS

Referrals were received from community urologists and obstetricians/gynecologists, and pain physicians at the Michael G. DeGroote Pain Clinic. Patients attended an orientation session, completed an interdisciplinary assessment, and if appropriate, attended an eight-day interdisciplinary CPP program. Each day consisted of group-based pelvic floor physiotherapy, psychoeducation, goal-setting, cognitive behavioral therapy, and mindfulness. Psychometric questionnaires were completed pre- and post-program by patients, and paired sample t-tests were used to evaluate the changes in patient-related outcomes after attending the program.

RESULTS

Thirty-seven female patients completed the program, and results demonstrate that the CPP program was associated with significant improvements in impact of pelvic pain on quality of life, readiness for change, and pain-related self-efficacy, as well as decreases in pain catastrophizing and fear of pain/re-injury.

CONCLUSIONS

CPP is a complex condition that requires interdisciplinary management and care. The results of this study demonstrate the short-term benefits of an interdisciplinary CPP program, highlight the unique needs of women with CPP, and implicate multiple factors for programming and treatment.

摘要

引言

慢性盆腔疼痛(CPP)是一个重要问题,约14%的女性在其一生中曾经历过慢性盆腔疼痛。虽然跨学科疼痛管理被认为是治疗的金标准,但在加拿大很少有项目提供这种类型的治疗。本文的目的是:1)描述一个跨学科慢性盆腔疼痛项目的发展;2)展示参加跨学科慢性盆腔疼痛项目后患者相关结局的变化。

方法

从社区泌尿科医生、妇产科医生以及迈克尔·G·德格罗特疼痛诊所的疼痛科医生处接收转诊患者。患者参加一次情况介绍会,完成一次跨学科评估,若合适,则参加为期八天的跨学科慢性盆腔疼痛项目。每天包括基于小组的盆底物理治疗、心理教育、目标设定、认知行为疗法和正念训练。患者在项目前后完成心理测量问卷,并使用配对样本t检验来评估参加项目后患者相关结局的变化。

结果

37名女性患者完成了该项目,结果表明慢性盆腔疼痛项目与盆腔疼痛对生活质量的影响、改变的意愿、与疼痛相关的自我效能感的显著改善相关,同时疼痛灾难化和对疼痛/再次受伤的恐惧也有所降低。

结论

慢性盆腔疼痛是一种需要跨学科管理和护理的复杂病症。本研究结果证明了跨学科慢性盆腔疼痛项目的短期益处,突出了慢性盆腔疼痛女性的独特需求,并暗示了项目规划和治疗的多个因素。

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本文引用的文献

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Learning to Manage Chronic Pain: The Patients' Perspective.学习管理慢性疼痛:患者视角。
Pain Ther. 2016 Jun;5(1):93-105. doi: 10.1007/s40122-016-0047-0. Epub 2016 Mar 2.

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