Montesinos Francisco, Páez Marisa, McCracken Lance M, Rodríguez-Rey Rocío, Núñez Susana, González Cristina, Díaz-Meco Raquel, Hernando Asunción
Department of Psychology, The School of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain.
Instituto ACT, Madrid, Spain.
Br J Pain. 2021 Feb;15(1):54-63. doi: 10.1177/2049463719884589. Epub 2019 Oct 29.
The aim of this study is to explore the effectiveness of a training programme aimed at managing patients' chronic pain in physiotherapy students in Spain. The programme addressed providing them with efficient skills to manage patients' chronic pain from psychological flexibility (PF) perspective.
The programme integrates communication skills training into PF-based training. It sought to contribute to better recognise the role of psychosocial factors in chronic pain and to better promote adherence to treatment. This is an observational study with a pre- and post-training programme design and a 2-month follow-up. A total of 35 physiotherapy students, divided into three groups, participated in a 10-hour training course. Training focused on three areas: (1) communication skills, (2) therapeutic adherence and (3) managing distress and pain. The three areas were addressed from the PF point of view. Impact of training was measured through standardised questionnaires that assessed attitudes towards chronic pain, an ad hoc questionnaire that assessed responses to difficult communicative situations and a training satisfaction scale.
Final analyses showed that attitudes changed significantly after training, biomedical attitude scores decreased and biopsychosocial attitude increased, while pain was considered less disabling, and informed empathic responses in communication situations increased. These changes were maintained at 2-month follow-up. Satisfaction with the training was high.
We conclude that a brief training programme based on the PF model may help students develop a more comprehensive approach and improve their skills for managing chronic pain.
本研究旨在探讨一项针对西班牙物理治疗专业学生管理患者慢性疼痛的培训计划的有效性。该计划旨在从心理灵活性（PF）的角度为他们提供管理患者慢性疼痛的有效技能。
该计划将沟通技能培训融入基于PF的培训中。它试图有助于更好地认识社会心理因素在慢性疼痛中的作用，并更好地促进对治疗的依从性。这是一项采用培训前和培训后设计以及为期2个月随访的观察性研究。共有35名物理治疗专业学生分为三组，参加了一个为期10小时的培训课程。培训集中在三个领域：（1）沟通技能，（2）治疗依从性，（3）管理痛苦和疼痛。这三个领域均从PF的角度进行探讨。通过评估对慢性疼痛态度的标准化问卷、评估对困难沟通情境反应的特设问卷以及培训满意度量表来衡量培训的影响。
最终分析表明，培训后态度发生了显著变化，生物医学态度得分下降，生物心理社会态度得分上升，同时疼痛被认为致残性降低，在沟通情境中明智的共情反应增加。这些变化在2个月的随访中得以维持。对培训的满意度很高。
我们得出结论，基于PF模型的简短培训计划可能有助于学生形成更全面的方法，并提高他们管理慢性疼痛的技能。
