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青少年慢性肌肉骨骼疼痛的复原力辅导的可行性与可接受性:一项单臂试点试验

The Feasibility and Acceptability of Resilience Coaching for Adolescent Chronic Musculoskeletal Pain: A Single-Arm Pilot Trial.

作者信息

Gmuca Sabrina, Weiss Pamela F, McGill Mackenzie, Xiao Rui, Ward Michaela, Nelson Maria, Sherry David D, Cronholm Peter F, Gerber Jeffrey S, Palermo Tonya M, Young Jami F, Rosenberg Abby R

机构信息

Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, 11-121, Philadelphia, PA 19146, USA.

Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA 19146, USA.

出版信息

Children (Basel). 2022 Sep 21;9(10):1432. doi: 10.3390/children9101432.

Abstract

Promoting Resilience in Stress Management (PRISM) is a well-established resilience coaching program for youth with chronic illness. It is a one-on-one intervention targeting skills in stress management, goal-setting, cognitive reframing, and meaning-making. We aimed to (i) assess the feasibility and acceptability of PRISM and (ii) explore PRISM's impact on clinical outcomes among youth with chronic musculoskeletal pain (CMP). This was a single-arm pilot trial of PRISM for youth with CMP aged 12-17 years. Patients completed patient-reported outcome measures (PROs) pre- and post- intervention; patients and caregivers provided qualitative feedback. Twenty-seven patients were enrolled (63% enrollment rate); 82% percent were female. The patients' median age was 16 years (IQR: 13-16). The intervention completion rate was 81% ( = 22). The mean satisfaction for PRISM overall was 4.3 (SD 0.9), while the mean acceptability of the intervention measure (AIM) was 4.4 (SD 0.89). Participants reported improved resilience (2.2 [SD 5.1]), functional disability (-3.5 [IQR: -6.0, 1.0]), and psychological distress (-1.0 [-5.0, 2.0]) from baseline to immediately post-treatment; pain intensity, pain catastrophizing, and global health were similar at both time points. Feedback was positive and suggested that a group component may be helpful. PRISM is feasible and acceptable among youth with CMP. Exploratory analyses suggest improvements in clinically relevant outcomes, warranting further investigation.

摘要

促进压力管理中的复原力(PRISM)是一项针对患有慢性病的青少年的成熟的复原力辅导计划。它是一种一对一的干预措施,旨在培养压力管理、目标设定、认知重构和意义构建等技能。我们旨在:(i)评估PRISM的可行性和可接受性;(ii)探讨PRISM对患有慢性肌肉骨骼疼痛(CMP)的青少年临床结局的影响。这是一项针对12至17岁患有CMP的青少年的PRISM单臂试点试验。患者在干预前后完成患者报告的结局指标(PROs);患者和护理人员提供了定性反馈。招募了27名患者(招募率为63%);82%为女性。患者的中位年龄为16岁(四分位间距:13 - 16岁)。干预完成率为81%( = 22)。PRISM总体平均满意度为4.3(标准差0.9),而干预措施可接受性(AIM)的平均得分为4.4(标准差0.89)。参与者报告从基线到治疗后即刻,复原力有所提高(2.2 [标准差5.1]),功能残疾有所改善(-3.5 [四分位间距:-6.0, 1.0]),心理困扰有所减轻(-1.0 [-5.0, 2.0]);两个时间点的疼痛强度、疼痛灾难化和总体健康状况相似。反馈是积极的,并表明小组部分可能会有帮助。PRISM在患有CMP的青少年中是可行且可接受的。探索性分析表明临床相关结局有所改善,值得进一步研究。

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