Gustavsson Catharina, von Koch Lena
Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden.
Health Expect. 2022 Jun;25(3):1157-1167. doi: 10.1111/hex.13469. Epub 2022 Mar 14.
(i) Describe patients' self-selected activity-related rehabilitation goals, and (ii) compare attainment of these rehabilitation goals among people with persistent tension-type neck pain receiving a group-based pain and stress self-management intervention (PASS) or individual physiotherapy (IPT).
Before intervention and random allocation to PASS or IPT, 156 people (PASS n = 77, IPT n = 79), listed three self-selected activity-related rehabilitation goals by use of the Patient Goal Priority Questionnaire (PGPQ). For each activity goal, participants rated limitations in activity performance, self-efficacy and fear of activity performance, readiness to change to improve performance, and expectations of future activity performance. At follow-ups (10 weeks, 20 weeks, 1 year and 2 years after inclusion), participants also responded to a question on changes made to improve activity performance. Mann-Whitney U test was used to evaluate between-group differences.
There were between-group differences in favour of PASS in the attainment of self-selected rehabilitation goals with regard to activity limitations and satisfaction with activity performance at all follow-ups.
PASS was more successful than IPT for the attainment of self-selected rehabilitation goals, improvements in activity limitations and satisfaction with activity performance as measured by PGPQ. The PASS programme emphasized the importance of applying active pain- and stress-coping techniques in personal 'risk situations' for pain flare-ups, which appear to support people with persistent tension-type neck pain to make changes in their lives to improve activity performance.
Patient engagement in rehabilitation by self-selected goals was investigated, but patients were not involved in the design or conduct of the study.
（i）描述患者自行选择的与活动相关的康复目标，以及（ii）比较接受基于小组的疼痛和压力自我管理干预（PASS）或个体物理治疗（IPT）的持续性紧张型颈部疼痛患者在实现这些康复目标方面的情况。
在干预和随机分配至PASS或IPT之前，156人（PASS组n = 77，IPT组n = 79）使用患者目标优先级问卷（PGPQ）列出了三个自行选择的与活动相关的康复目标。对于每个活动目标，参与者对活动表现的限制、自我效能感、对活动表现的恐惧、为改善表现而改变的意愿以及对未来活动表现的期望进行了评分。在随访时（纳入后10周、20周、1年和2年），参与者还回答了关于为改善活动表现所做改变的问题。采用曼-惠特尼U检验评估组间差异。
在所有随访中，在实现自行选择的康复目标方面，就活动限制和对活动表现的满意度而言，PASS组比IPT组更具优势。
就PGPQ所衡量的自行选择的康复目标的实现、活动限制的改善以及对活动表现的满意度而言，PASS比IPT更成功。PASS计划强调了在个人疼痛发作的“风险情况”中应用积极的疼痛和压力应对技巧的重要性，这似乎有助于持续性紧张型颈部疼痛患者在生活中做出改变以改善活动表现。
对患者通过自行选择的目标参与康复进行了调查，但患者未参与研究的设计或实施。
