Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5020 Bergen, Norway.
Department of Addiction Medicine, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway.
Int J Environ Res Public Health. 2020 Dec 17;17(24):9468. doi: 10.3390/ijerph17249468.
Chronic pain is common among refugees, and often related to mental health problems. Its management, however, is often challenging. A randomized waitlist-controlled trial was designed to study the effect of group physiotherapy activity and awareness intervention (PAAI) on reducing pain disorders, and secondarily improving mental health, among Syrian refugees. A total of 101 adult Syrian refugees suffering from chronic pain were randomized to either the intervention group or the control group, which thereafter also received PAAI after a waiting period. Pain intensity measured by the Brief Pain Inventory (BPI) was the primary outcome. Scores from the Impact of Events Scale-Revised (IES-R 22) and the General Health Questionnaire (GHQ-12) were secondary outcomes. Intention-to-treat analyses (ITT) showed no effect of the intervention on either pain levels (regression coefficient [B {95% CI} of 0.03 {-0.91, 0.96}], IESR scores [4.8 {-3.7, 13.4}] or GHQ-12 scores [-0.4 {-3.1, 2.3}]). Yet, participants highly appreciated the intervention. Despite the negative findings, our study contributes to the evidence base necessary to plan targeted and effective health care services for refugees suffering from chronic pain and highlights the challenge of evaluating complex interventions adapted to a specific group.
慢性疼痛在难民中很常见，且常与心理健康问题有关。然而，其管理往往具有挑战性。本研究设计了一项随机等待对照试验，旨在研究团体物理治疗活动和意识干预（PAAI）对减轻慢性疼痛的叙利亚难民的疼痛障碍的影响，其次是改善心理健康。共有 101 名患有慢性疼痛的成年叙利亚难民被随机分配到干预组或对照组，对照组在等待一段时间后也接受了 PAAI。使用简明疼痛量表（BPI）测量疼痛强度为主要结局。修订后的事件影响量表（IES-R 22）和一般健康问卷（GHQ-12）的评分是次要结局。意向治疗分析（ITT）显示，干预对疼痛水平（回归系数 [0.03 {95%CI} -0.91, 0.96]）、IESR 评分（4.8 {-3.7, 13.4}]）或 GHQ-12 评分[-0.4 {-3.1, 2.3}]）均无影响。然而，参与者非常赞赏该干预措施。尽管研究结果为阴性，但本研究为计划针对患有慢性疼痛的难民提供有针对性和有效的医疗保健服务提供了必要的证据基础，并强调了评估针对特定群体的复杂干预措施的挑战。
