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慢性疼痛治疗后患者自我改善认知的相关因素。

Factors involved in patients' perceptions of self-improvement after chronic pain treatment.

作者信息

Shaikh Majidullah, Hapidou Eleni G

机构信息

Department of Psychology, Neuroscience and Behaviour (PNB), McMaster University, Hamilton, ON, Canada.

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

出版信息

Can J Pain. 2018 Jun 18;2(1):145-157. doi: 10.1080/24740527.2018.1476821. eCollection 2018.

Abstract

BACKGROUND

Patients' self-reported levels of improvement after having attended a chronic pain management program can provide a subjective rating of how successful they perceive they were at accomplishing their goals in the program. Past studies have demonstrated that successful patients differ from less successful ones on several cognitive-behavioral factors such as coping strategies over physical characteristics such as pain intensity.

AIMS

This study explored factors that determine patients' perceptions of self-improvement after undergoing chronic pain treatment in a pain management program.

METHODS

Participants ( = 174) underwent a 4-week, interdisciplinary, multimodal, chronic pain management program at a hospital located in southern Ontario. Questionnaire packages that evaluate pain intensity, pain-related disability, emotional distress (e.g., depression, anxiety, catastrophizing), acceptance of pain (activity engagement and pain willingness), readiness to change, and use of adaptive or maladaptive coping strategies were completed by patients at admission and discharge. Participants were grouped into one of three categories depending on their rating of self-improvement on the Self-Evaluation Scale (SES). The groups were compared on the magnitude of change they reported on the variables mentioned above.

RESULTS

Changes in emotional distress, general health, readiness to change, activity engagement, and adaptive coping strategies (e.g., task persistence, pacing, and seeking social support) were significantly associated with differences in ratings of self-improvement.

CONCLUSIONS

This study provided insight into what patients value most when rating their self-improvement, which can then be used to facilitate increased patient success and satisfaction with treatment.

摘要

背景

患者参加慢性疼痛管理项目后自我报告的改善程度,可以提供一个主观评分,以衡量他们认为自己在实现项目目标方面有多成功。过去的研究表明,成功的患者与不太成功的患者在一些认知行为因素上存在差异,比如应对策略,而不是像疼痛强度这样的身体特征。

目的

本研究探讨了在疼痛管理项目中,决定患者对慢性疼痛治疗后自我改善认知的因素。

方法

174名参与者在安大略省南部的一家医院参加了一个为期4周的跨学科、多模式的慢性疼痛管理项目。患者在入院和出院时完成了问卷包,问卷包评估了疼痛强度、与疼痛相关的残疾、情绪困扰(如抑郁、焦虑、灾难化)、对疼痛的接受度(活动参与度和疼痛意愿)、改变的准备情况以及适应性或适应不良应对策略的使用情况。根据参与者在自我评估量表(SES)上对自我改善的评分,将他们分为三类之一。比较了三组在上述变量上报告的变化幅度。

结果

情绪困扰、总体健康状况、改变的准备情况、活动参与度和适应性应对策略(如任务坚持性、节奏控制和寻求社会支持)的变化与自我改善评分的差异显著相关。

结论

本研究深入了解了患者在对自我改善进行评分时最看重的因素,这些因素随后可用于提高患者治疗的成功率和满意度。

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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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Patient-centered perspective on treatment outcomes in chronic pain.从患者角度看待慢性疼痛的治疗结果。
Pain Med. 2010 Jan;11(1):6-15. doi: 10.1111/j.1526-4637.2009.00685.x. Epub 2009 Sep 1.

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