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探讨数字接纳与承诺疗法治疗慢性疼痛的疗效预测因素。

Examining predictors of treatment effect in digital Acceptance and Commitment Therapy for chronic pain.

机构信息

Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden.

出版信息

Cogn Behav Ther. 2023 Jul;52(4):380-396. doi: 10.1080/16506073.2023.2191826. Epub 2023 Mar 27.

Abstract

Digitally delivered behavioral interventions for chronic pain have been encouraging with effects similar to face-to-face treatment. Although many chronic pain patients benefit from behavioral treatment, a substantial proportion do not improve. To contribute to more knowledge about factors that predict treatment effects in digitally delivered behavioral interventions for chronic pain, the present study analyzed pooled data ( = 130) from three different studies on digitally delivered Acceptance and Commitment Therapy (ACT) for chronic pain. Longitudinal linear mixed-effects models for repeated measures were used to identify variables with significant influence on the rate of improvement in the main treatment outcome pain interference from pre- to post-treatment. The variables were sorted into six domains (demographics, pain variables, psychological flexibility, baseline severity, comorbid symptoms and early adherence) and analysed in a stepwise manner. The study found that shorter pain duration and higher degree of insomnia symptoms at baseline predicted larger treatment effects. The original trials from which data was pooled are registered at clinicaltrials.gov (registration number: NCT03105908 and NCT03344926).

摘要

数字化传递的慢性疼痛行为干预措施效果令人鼓舞,与面对面治疗效果相似。虽然许多慢性疼痛患者从行为治疗中受益,但仍有相当一部分患者没有改善。为了更深入地了解数字化传递的慢性疼痛行为干预措施中预测治疗效果的因素,本研究分析了三项不同的数字化接受与承诺疗法(ACT)治疗慢性疼痛研究的汇总数据(n=130)。采用重复测量的纵向线性混合效应模型,确定对从治疗前到治疗后主要治疗结果疼痛干扰的改善率有显著影响的变量。这些变量被分为六个领域(人口统计学、疼痛变量、心理灵活性、基线严重程度、共病症状和早期依从性),并逐步进行分析。研究发现,基线时疼痛持续时间较短和失眠症状程度较高预示着更大的治疗效果。数据汇总所依据的原始试验已在 clinicaltrials.gov 注册(注册号:NCT03105908 和 NCT03344926)。

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