INPUT Pain Management Unit, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
Health Psychology Section, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Guy's Hospital, Great Maze Pond, SE1 9RT, UK.
Physiotherapy. 2022 Sep;116:33-41. doi: 10.1016/j.physio.2022.01.004. Epub 2022 Feb 2.
Physiotherapists increasingly deliver treatment informed by cognitive-behavioural therapy, including Acceptance and Commitment Therapy (ACT), for persistent pain. This study explored patients' experiences of ACT-informed physiotherapy to better understand therapeutic processes and outcomes.
A qualitative descriptive study was conducted. Focus groups explored participants' experience of ACT-informed physiotherapy in the context of a pain management programme. Responses were audio recorded, transcribed verbatim, and analysed using a hybrid inductive-deductive reflexive thematic analysis.
A single tertiary care pain management service.
The sample consisted of fifteen patients from two treatment groups who completed an intensive multidisciplinary ACT-based pain management programme. Participants were included irrespective of their treatment response.
One overarching theme (living more and struggling less) and four interconnected themes were generated from the data: 1) awareness and openness help to approach physical activities flexibly; 2) from battling against to working with the body compassionately; 3) from narrow focus to curiosity, freedom, and expansion; and 4) social connection is a catalyst for openness and engagement.
Participants experienced ACT-informed physiotherapy as helping them to live more and struggle less with pain; this occurred in the context of a psychologically flexible relationship with the physiotherapist and was catalysed by social connection. These findings should be seen as preliminary given the small number and relatively brief duration of focus groups conducted. Further research is needed to explore how principles within ACT-informed physiotherapy may support patients and clinicians to respond effectively to the challenges that persistent pain can bring.
物理治疗师越来越多地根据认知行为疗法（包括接纳与承诺疗法（ACT））为持续性疼痛提供治疗。本研究探讨了患者对基于 ACT 的物理治疗的体验，以更好地了解治疗过程和结果。
本研究采用定性描述性研究。焦点小组探讨了参与者在疼痛管理计划背景下接受基于 ACT 的物理治疗的体验。使用混合归纳演绎反思主题分析方法对响应进行音频记录、逐字转录和分析。
一个单一的三级护理疼痛管理服务。
来自两个治疗组的十五名患者完成了一个密集的多学科基于 ACT 的疼痛管理计划。无论治疗反应如何，都包括参与者。
从数据中产生了一个总体主题（更多地生活，更少地挣扎）和四个相互关联的主题：1）意识和开放性有助于灵活地进行体育活动；2）从与身体对抗到同情地合作；3）从狭隘的焦点到好奇、自由和扩展；4）社会联系是开放和参与的催化剂。
参与者体验到基于 ACT 的物理治疗有助于他们更多地生活，更少地与疼痛作斗争；这是在与物理治疗师建立心理灵活关系的背景下发生的，并由社会联系催化。鉴于进行的焦点小组数量较少且相对短暂，这些发现应被视为初步结果。需要进一步研究来探讨基于 ACT 的物理治疗中的原则如何支持患者和临床医生有效应对持续性疼痛带来的挑战。
