Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Psychology, University of Bern, Bern, Switzerland.
J Clin Psychol Med Settings. 2024 Mar;31(1):48-57. doi: 10.1007/s10880-023-09958-0. Epub 2023 Apr 20.
As motivation for psychological treatment at intake has been shown to predict favorable outcomes after an inpatient stay, this study aimed to further characterize the different components of psychological treatment motivation that predict favorable treatment outcomes. 294 inpatients with chronic primary pain participating in an interdisciplinary multimodal pain treatment in a tertiary psychosomatic university clinic completed a battery of psychological questionnaires at intake and discharge. Treatment motivation was assessed at intake using the scales of the FPTM-23 questionnaire, while pain intensity, pain interference, anxiety, and depression were assessed both at intake and discharge. After treatment, pain intensity, pain interference, anxiety, and depression were significantly reduced. While higher levels on the FPTM-23 scale of suffering predicted smaller decreases in anxiety after treatment, higher scores on the scale of hope, i.e., lower levels of hopelessness, predicted lower levels of pain interference, anxiety, and depression after treatment. None of the scales of treatment motivation predicted pain intensity levels after treatment. Above and beyond providing symptom relief, reducing hopelessness and fostering hope regarding the treatment process and outcome might help clinicians treat patients with chronic primary pain more effectively.
由于治疗开始时的心理治疗动机已被证明可预测住院后的良好结果,因此本研究旨在进一步描述预测治疗结果良好的不同心理治疗动机成分。294 名患有慢性原发性疼痛的住院患者在一所三级身心大学诊所参加了跨学科多模式疼痛治疗,在入组和出院时完成了一系列心理问卷。使用 FPTM-23 问卷的量表在入组时评估治疗动机,而在入组和出院时评估疼痛强度、疼痛干扰、焦虑和抑郁。治疗后,疼痛强度、疼痛干扰、焦虑和抑郁均显著降低。虽然 FPTM-23 量表的痛苦水平越高,治疗后焦虑的降低幅度越小,但希望量表的得分越高,即无望感越低,预示着治疗后疼痛干扰、焦虑和抑郁的水平越低。治疗动机的任何量表都不能预测治疗后的疼痛强度水平。除了缓解症状外,减少对治疗过程和结果的绝望感并培养希望感可能有助于临床医生更有效地治疗患有慢性原发性疼痛的患者。