Sweeney Louise, Moss-Morris Rona, Czuber-Dochan Wladyslawa, Norton Christine
Health Psychology Section, King's College London, London, UK.
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.
Pilot Feasibility Stud. 2021 Apr 16;7(1):95. doi: 10.1186/s40814-021-00829-9.
Chronic pain is a poorly managed symptom of inflammatory bowel disease (IBD). Cognitive behavioural therapy (CBT) has an evidence base in functional gastrointestinal conditions and chronic pain. This study aimed to test the feasibility and acceptability of a 9-week online facilitator-supported CBT intervention, tailored for people with chronic IBD-related pain.
A single-arm pre-post design with nested qualitative interviews was used. Twenty individuals with IBD and chronic pain were recruited through an online IBD charity and had consented to research in a previous survey or responded to an online charity advert. Individuals who indicated a pain-interference score of ≥ 4/10 (Brief Pain Inventory) and met inclusion criteria were invited to take part. Outcomes included recruitment and retention rates, pain interference and severity, quality of life (QoL) and psychosocial measures.
Of 145 individuals contacted, 55 (37.9%) responded. Two individuals were recruited from the study advertisement. Twenty out of 57 (35.1%) met screening and eligibility criteria. Eighty-five percent of the sample engaged with intervention sessions and 55% completed at least 5/9 sessions. Eighty percent of recruited participants completed the post-intervention questionnaire at week 9. The mean score for overall acceptability was 43.4 (0-70). Qualitative feedback demonstrated the value of thought monitoring and facilitator support. Scores improved for QoL and pain self-efficacy and reduced for depression, anxiety, pain catastrophising and avoidance resting behaviour.
Online CBT for chronic IBD-related pain appears feasible and acceptable. The study suggests positive effects for improving QoL and reducing psychological distress; however, online and face-to-face recruitment methods are recommended and establishing efficacy through larger randomised controlled trials is required.
慢性疼痛是炎症性肠病（IBD）中一种管理不善的症状。认知行为疗法（CBT）在功能性胃肠疾病和慢性疼痛方面有证据支持。本研究旨在测试一种为期9周的在线辅导员支持的CBT干预措施的可行性和可接受性，该干预措施是为患有慢性IBD相关疼痛的人群量身定制的。
采用单组前后设计并进行嵌套定性访谈。通过一个在线IBD慈善机构招募了20名患有IBD和慢性疼痛的个体，他们在之前的一项调查中同意参与研究或回应了在线慈善广告。那些表明疼痛干扰评分≥4/10（简明疼痛量表）且符合纳入标准的个体被邀请参加。结果包括招募率和保留率、疼痛干扰和严重程度、生活质量（QoL）以及心理社会指标。
在联系的145名个体中，55名（37.9%）做出了回应。从研究广告中招募了2名个体。57名中的20名（35.1%）符合筛查和资格标准。85%的样本参与了干预课程，55%完成了至少5/9节课程。80%的招募参与者在第9周完成了干预后问卷。总体可接受性的平均评分为43.4（0 - 70）。定性反馈表明了思维监测和辅导员支持的价值。QoL和疼痛自我效能得分有所提高，而抑郁、焦虑、疼痛灾难化和回避静止行为得分有所降低。
针对慢性IBD相关疼痛的在线CBT似乎是可行且可接受的。该研究表明对改善QoL和减轻心理困扰有积极作用；然而，建议采用在线和面对面的招募方法，并需要通过更大规模的随机对照试验来确定疗效。
