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