Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, 89081 Ulm, Germany.
Department of Research Methods, Institute of Psychology and Education, University of Ulm, 89081 Ulm, Germany.
Int J Environ Res Public Health. 2022 Oct 25;19(21):13858. doi: 10.3390/ijerph192113858.
Musculoskeletal symptoms are increased in farmers, whereas the prevalence of chronified pain is unknown. Online interventions based on acceptance and commitment therapy (ACT) have shown encouraging results in the general population, representing a promising approach for reducing pain interference in green professions (i.e., farmers, foresters, gardeners). We conducted a pragmatic RCT comparing a guided ACT-based online intervention to enhanced treatment-as-usual in entrepreneurs, contributing spouses, family members and pensioners in green professions with chronic pain (CPG: ≥grade II, ≥6 months). Recruitment was terminated prematurely after 2.5 years at = 89 (of planned = 286). Assessments were conducted at 9 weeks (T1), 6 months (T2) and 12 months (T3) post-randomization. The primary outcome was pain interference (T1). The secondary outcomes encompassed pain-, health- and intervention-related variables. No treatment effect for reduction of pain interference was found at T1 (β = -0.16, 95%CI: -0.64-0.32, = 0.256). Improvements in cognitive fusion, pain acceptance, anxiety, perceived stress and quality of life were found only at T3. Intervention satisfaction as well as therapeutic and technological alliances were moderate, and uptake and adherence were low. Results are restricted by low statistical power due to recruitment issues, high study attrition and low intervention adherence, standing in contrast to previous studies. Further research is warranted regarding the use of ACT-based online interventions for chronic pain in this occupational group. Trial registration: German Clinical Trial Registration: DRKS00014619. Registered: 16 April 2018.
肌肉骨骼症状在农民中更为常见，而慢性疼痛的患病率尚不清楚。基于接受和承诺疗法（ACT）的在线干预在普通人群中已显示出令人鼓舞的结果，代表了一种减少绿色职业（即农民、林务员、园丁）中疼痛干扰的有前途的方法。我们进行了一项实用的 RCT，比较了基于指导的 ACT 的在线干预与增强的常规治疗，针对患有慢性疼痛（CPG：≥II 级，≥6 个月）的绿色职业中的企业家、配偶、家庭成员和养老金领取者。在计划的 = 286 人中，经过 2.5 年的提前招募， = 89 人提前终止。评估在随机分组后 9 周（T1）、6 个月（T2）和 12 个月（T3）进行。主要结局是疼痛干扰（T1）。次要结局包括疼痛、健康和干预相关变量。在 T1 时未发现减少疼痛干扰的治疗效果（β = -0.16，95%CI：-0.64-0.32， = 0.256）。仅在 T3 时发现认知融合、疼痛接受、焦虑、感知压力和生活质量的改善。干预满意度以及治疗和技术联盟均为中等，而参与度和依从性较低。由于招募问题、高研究流失率和低干预依从性，导致统计效力低，结果受到限制，与之前的研究结果相反。对于在这个职业群体中使用基于 ACT 的在线干预治疗慢性疼痛，还需要进一步研究。
德国临床试验注册：DRKS00014619。注册日期：2018 年 4 月 16 日。
