针对合并疼痛和抑郁的工作残疾管理的风险靶向行为激活：一项可行性研究。
Risk-targeted behavioral activation for the management of work disability associated with comorbid pain and depression: a feasibility study.
作者信息
Sullivan Michael J L, Wideman Timothy H, Gauthier Nathalie, Thibault Pascal, Ellis Tamra, Adams Heather
机构信息
Department of Psychology, McGill University, Montreal, QC, H3A 1G1, Canada.
School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
出版信息
Pilot Feasibility Stud. 2022 Apr 23;8(1):90. doi: 10.1186/s40814-022-01040-0.
PURPOSE
The purpose of the present study was to conduct a preliminary evaluation of the feasibility and impact of a risk-targeted behavioral activation intervention for work-disabled individuals with comorbid pain and depression.
METHODS
The design of the study was a single-arm non-randomized trial. The sample consisted of 66 work-disabled individuals with comorbid pain and depression. The treatment program consisted of a 10-week standardized behavioral activation intervention supplemented by techniques to target two psychosocial risk factors for delayed recovery, namely, catastrophic thinking and perceptions of injustice. Measures of pain severity, depression, catastrophic thinking, perceived injustice, and self-reported disability were completed pre-, mid-, and post-treatment. Satisfaction with treatment was assessed at post-treatment. Return to work was assessed at 6-month follow-up.
RESULTS
The drop-out rate was 18%. At treatment termination, 91% of participants indicated that they were "very" or "completely" satisfied with their involvement in the treatment program. Significant reductions in pain (Cohen's d = 0.71), depression (d = 0.86), catastrophic thinking (d = 1.1), and perceived injustice (d = 1.0) were observed through the course of treatment. In multivariate analyses, treatment-related reductions in depression, catastrophic thinking, and perceived injustice, but not pain, contributed significant unique variance to the prediction of return-to-work outcomes.
CONCLUSIONS
Risk-targeted behavioral activation was found to be an acceptable and effective intervention for work-disabled individuals with comorbid pain and depression. The findings suggest that interventions targeting psychosocial risk factors for pain and depression might contribute to more positive recovery outcomes in work-disabled individuals with comorbid pain and depression.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT0517442 . Retrospectively registered.
目的
本研究旨在对针对患有疼痛和抑郁症的工作残疾个体的风险靶向行为激活干预措施的可行性和影响进行初步评估。
方法
本研究设计为单臂非随机试验。样本包括66名患有疼痛和抑郁症的工作残疾个体。治疗方案包括为期10周的标准化行为激活干预，并辅以针对延迟康复的两个心理社会风险因素（即灾难化思维和不公正感）的技术。在治疗前、治疗中期和治疗后完成疼痛严重程度、抑郁、灾难化思维、感知不公正和自我报告残疾的测量。在治疗后评估对治疗的满意度。在6个月随访时评估重返工作情况。
结果
脱落率为18%。在治疗结束时，91%的参与者表示他们对参与治疗方案“非常”或“完全”满意。在治疗过程中观察到疼痛（科恩d值 = 0.71）、抑郁（d = 0.86）、灾难化思维（d = 1.1）和感知不公正（d = 1.0）显著降低。在多变量分析中，与治疗相关的抑郁、灾难化思维和感知不公正的降低（而非疼痛）对重返工作结果的预测贡献了显著的独特方差。
结论
风险靶向行为激活被发现是针对患有疼痛和抑郁症的工作残疾个体的一种可接受且有效的干预措施。研究结果表明，针对疼痛和抑郁症的心理社会风险因素的干预措施可能有助于患有疼痛和抑郁症的工作残疾个体获得更积极的康复结果。
试验注册
ClinicalTrials.gov：NCT0517442。回顾性注册。
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