一项在线接受和承诺疗法治疗女性境遇性外阴痛的可行性试验。

A feasibility trial of online Acceptance and Commitment Therapy for women with provoked vestibulodynia.

机构信息

Department of Psychology, Division of Clinical Psychology, Uppsala University, Uppsala, Sweden.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

出版信息

Scand J Pain. 2023 Jul 3;23(3):476-482. doi: 10.1515/sjpain-2022-0146. Print 2023 Jul 26.

DOI:10.1515/sjpain-2022-0146

PMID:37401654

Abstract

OBJECTIVES

Acceptance and Commitment Therapy (ACT) is an established treatment for chronic pain. However, it is a form of treatment that have not yet been applied much in the treatment of persistent vulvar pain disorders. This study examines the feasibility and preliminary effects of online ACT for patients with provoked vestibulodynia.

METHODS

Women diagnosed with provoked vestibulodynia were assigned randomly either to online ACT or to a waitlist control group. Feasibility was assessed in terms of recruitment potential, treatment credibility, completions rates, retention in trial, and data quality. Participants completed measures of pain with sexual activity, sexual functioning, emotional and relational adjustment, and potential treatment processes before and after treatment.

RESULTS

Of the 111 women who were invited to participate in the study, 44 were included (39.6 % recruitment rate). Thirty seven participants (84.1 %) completed the pre-treatment assessment. Participants who received online ACT rated treatment credibility positively, and completed on average 4.31 (SD=1.60) of the six treatment modules. Of participants, 34 provided post treatment data, giving a trial retention rate of 77 %. Effects of online ACT, as compared to waitlist, were large for pain acceptance and quality of life, medium for anxiety and pain catastrophizing, and small for sexual satisfaction, pain with sexual activity, and relationship adjustment.

CONCLUSIONS

With some adjustments to recruitment procedures, a full scale randomized controlled trial of online ACT for provoked vestibulodynia appears feasible.

摘要

目的

接受与承诺疗法（ACT）是一种成熟的慢性疼痛治疗方法。然而，它是一种尚未广泛应用于持续性外阴疼痛障碍治疗的治疗方法。本研究考察了在线 ACT 对唤起性外阴疼痛患者的可行性和初步疗效。

方法

被诊断为唤起性外阴疼痛的女性被随机分配到在线 ACT 组或等待名单对照组。根据招募潜力、治疗可信度、完成率、试验保留率和数据质量来评估可行性。参与者在治疗前后完成了与性行为相关的疼痛、性功能、情绪和关系调整以及潜在治疗过程的测量。

结果

在受邀参加研究的 111 名女性中，有 44 名女性（39.6%的招募率）入组。37 名参与者（84.1%）完成了治疗前评估。接受在线 ACT 的参与者对治疗可信度给予了积极评价，平均完成了 6 个治疗模块中的 4.31 个（SD=1.60）。有 34 名参与者提供了治疗后数据，试验保留率为 77%。与等待名单相比，在线 ACT 的治疗效果在疼痛接受度和生活质量方面有很大的改善，在焦虑和疼痛灾难化方面有中等的改善，在性满意度、性行为相关疼痛和关系调整方面有较小的改善。