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基层医疗中的慢性疼痛的简要心理干预:一项试点随机临床试验的长期效果研究。

A brief psychological intervention for chronic pain in primary care: Examining long-term effects from a pilot randomized clinical trial.

机构信息

Behavioral Health, Henry Ford Health, Detroit, Michigan, USA.

Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan, USA.

出版信息

Pain Pract. 2022 Jul;22(6):564-570. doi: 10.1111/papr.13134. Epub 2022 Jun 14.

DOI:10.1111/papr.13134
PMID:35665994
Abstract

BACKGROUND

Despite the existence of evidence-based psychological interventions for pain management, there are barriers that interfere with treatment engagement. A brief intervention integrated into primary care reduced barriers and showed promising benefits from pre- to post-intervention. However, it is unknown whether a brief intervention can provide long-term effects. The purpose of this study was to examine whether a brief psychological intervention offered benefits in pain severity, pain interference, pain catastrophizing, and depressive symptoms at 1- and 6-month follow-ups.

METHODS

The majority of participants who enrolled in a pilot randomized clinical trial of a 5-session psychological intervention for chronic pain in primary care completed the 1-month (n = 54; 90%) and 6-month follow-ups (n = 50; 83.3%). Participants completed measures of pain severity, pain interference, pain catastrophizing, and depressive symptoms.

RESULTS

From baseline to the 6-month follow-up, those in the intervention group had significantly better outcomes for pain severity (p = 0.01) and pain catastrophizing (p = 0.003) compared with the control group. There were no significant differences between the intervention and control groups for pain interference and depression. The percentage of patients in the intervention experiencing clinically significant improvement across all outcomes was higher than the control group.

CONCLUSIONS

Findings suggest that a brief psychological intervention for chronic pain in primary care may offer longer-term benefits similar to that of lengthier interventions. Future studies should examine this through a randomized clinical trial with a larger sample size.

摘要

背景

尽管存在基于证据的心理干预措施来管理疼痛,但仍存在一些障碍会干扰治疗的参与。一项整合在初级保健中的简短干预措施减少了障碍,并显示出从干预前到干预后的有希望的益处。然而,目前尚不清楚简短的干预是否能提供长期效果。本研究的目的是检验在 1 个月和 6 个月的随访中,一项简短的心理干预是否能在疼痛严重程度、疼痛干扰、疼痛灾难化和抑郁症状方面提供益处。

方法

大多数参加初级保健中慢性疼痛的 5 次心理干预的试点随机临床试验的参与者完成了 1 个月(n=54;90%)和 6 个月的随访(n=50;83.3%)。参与者完成了疼痛严重程度、疼痛干扰、疼痛灾难化和抑郁症状的测量。

结果

从基线到 6 个月的随访,干预组在疼痛严重程度(p=0.01)和疼痛灾难化(p=0.003)方面的结果明显优于对照组。干预组和对照组在疼痛干扰和抑郁方面没有显著差异。在所有结局中,经历临床显著改善的干预组患者的比例高于对照组。

结论

研究结果表明,初级保健中的慢性疼痛简短心理干预可能提供与较长干预相似的长期益处。未来的研究应该通过一项具有更大样本量的随机临床试验来检验这一点。

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