School of Health and Life Sciences, Teesside University, Middlesbrough, UK
School of Health and Life Sciences, Teesside University, Middlesbrough, UK.
BMJ Open Qual. 2021 May;10(2). doi: 10.1136/bmjoq-2020-001068.
Evaluate the outcomes and explore experiences of patients undergoing a residential combined physical and psychological programme (CPPP) for chronic low back pain.
A longitudinal observational cohort design, with a parallel qualitative design using semistructured interviews.
Residential, multimodal rehabilitation.
136 adults (62 male/74 female) referred to the CPPP, 100 (44 male/56 female) of whom completed the programme, during the term of the study. Ten (2 male/8 female) participated in the qualitative evaluation.
A 3-week residential CPPP.
Primary outcome measures were the STarT Back screening tool score; pain intensity-11-point Numerical Rating Scale; function-Oswestry Disability Index (ODI); health status/quality of life-EQ-5D-5L EuroQol five-Dimension-five level; anxiety-Generalised Anxiety Disorder-7; depression-Patient Health Questionnaire-9. Secondary outcome measures were the Global Subjective Outcome Scale; National Health Service Friends and Family Test;.
At discharge, 6 and 12 months follow ups, there were improvements from baseline that were greater than minimum clinically important differences in each of the outcomes (with the sole exception of ODI at discharge). At 12 months, the majority of people considered themselves a lot better (57%) and were extremely likely (86%) to recommend the programme to a friend. The qualitative data showed praise for the residential nature of the intervention and the opportunities for interaction with peers and peer support. There were testimonies of improvements in understanding of pain and how to manage it better. Some participants said they had reduced, or stopped, medication they had been taking to manage their pain.
Participants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.
评估接受综合性身心治疗计划（CPPP）的慢性腰痛患者的治疗结果并探索其体验。
纵向观察性队列设计，同时采用半结构化访谈的平行定性设计。
住院，多模式康复。
136 名成年人（62 名男性/74 名女性）被转诊至 CPPP，其中 100 名（44 名男性/56 名女性）完成了该计划，研究期间，10 名（2 名男性/8 名女性）参与者参与了定性评估。
为期 3 周的住院 CPPP。
主要结果指标为 STAR 腰痛筛查工具评分、疼痛强度-11 点数字评分量表、功能-Oswestry 残疾指数（ODI）、健康状况/生活质量-EQ-5D-5L 欧洲五维健康量表、焦虑-GAD-7 量表、抑郁-PHQ-9 量表。次要结果指标包括全球主观治疗结果量表、NHS 朋友和家人测试。
在出院时、6 个月和 12 个月的随访中，与基线相比，每个结果都有改善，且均大于最小临床重要差异（除出院时 ODI 外）。在 12 个月时，大多数人认为自己改善很多（57%），并非常有可能（86%）向朋友推荐该计划。定性数据显示，参与者称赞该干预措施的住院性质以及与同伴互动和获得同伴支持的机会。有参与者表示，他们对疼痛的理解以及更好地管理疼痛的能力有所提高。一些参与者表示他们已经减少或停止了用于管理疼痛的药物。
参与者在广泛的结果方面都得到了改善，并长期保持在最小临床重要差异以上。参与者报告说，他们自我管理腰痛的能力得到了提高，并支持住院环境。
