Ruiz Romero María Victoria, López Tarrida Ángeles Carmen, Porrúa Del Saz Ana, Gómez Hernández María Begoña, Martínez Monrobé María Blanca, Sánchez Villar Elena, Cruz Valero Carlos, Pereira Delgado Consuelo
Responsable de Calidad e Investigación; Hospital San Juan de Dios del Aljarafe. Bormujos (Sevilla). España.
Servicio de Cuidados Críticos y Urgencias; Hospital San Juan de Dios del Aljarafe. Bormujos (Sevilla). España.
Rev Esp Salud Publica. 2023 Sep 6;97:e202309071.
OBJECTIVE: The prevalence of chronic pain in Spain is 17%, which causes suffering and significant loss of quality of life. Therapies should not focus only on pain reduction, to improve function and quality of life are necessary. Currently, it is committed to combining drugs and other therapies such as relaxation, meditation, cognitive behavioral therapy, targeted exercises, healthy lifestyles and techniques to increase self-esteem and motivation for change. These therapies can be used as part of a multimodal approach, forming part of multicomponent programs or workshops. In this paper we proposed to evaluate the effectiveness of a workshop developed from the Hospital San Juan de Dios del Ajarafe, that integrated different non-pharmacological therapies in the control of chronic non-oncologic pain and to analyze patients' perceptions of the techniques applied and how they affected pain and lifestyles. METHODS: An intragroup before-after study (beginning-end of the workshop) was carried out, comparing pain, well-being, drug use, quality of life, and self-esteem. Surveys were conducted to deepen more qualitative aspects and identify improvements. The workshop consisted of psychoeducational action and training for the mental control of pain and emotions, based on the active participation of the patient in the management of his disease, promoting self-care and self-esteem, and aiming to improve well-being and quality of life. It consisted of 5 sessions of 3 hours (1 per week); of a group, interactive and practical nature. Statistical analysis was performed with SPSS vs.27.0. To compare related measures (before-after) we used Student's T tests for paired samples and Wilcoxon's test and to compare independent groups, Student's T and Mann Whitney's U; for the qualitative variables, we used Chi-Square and Fisher's test. RESULTS: Four workshops were evaluated in which 63 patients participated, with a mean age of 57.6 (SD:11.37) years, 60 (95.2%) of them were women. At the end of the workshop pain decreased 1.5 median (-2.0-0) and well-being increased 2.0 (0-2.0); quality of life increased a median of 0.121 (SD: 0.209), health status 16.8 (23.78) and self-esteem 2.74 (4.73); [p<0.001]. The best valued techniques were meditations, mainly mental analgesia, affirmations in the mirror and self-esteem techniques. CONCLUSIONS: Overall satisfaction with the workshop is 9.8 out of 10. There is a pain control and improvement in quality of life, self-perception of health status, well-being and self-esteem.
目的:西班牙慢性疼痛的患病率为17%,这会导致痛苦并严重降低生活质量。治疗不应仅专注于减轻疼痛,改善功能和生活质量也很有必要。目前,人们致力于将药物与其他疗法相结合,如放松、冥想、认知行为疗法、针对性锻炼、健康的生活方式以及提升自尊和改变动力的技巧。这些疗法可作为多模式方法的一部分,成为多组分项目或工作坊的组成部分。在本文中,我们提议评估由阿哈拉费圣胡安·德迪奥斯医院开展的一个工作坊的效果,该工作坊整合了不同的非药物疗法来控制慢性非肿瘤性疼痛,并分析患者对所应用技巧的看法以及这些技巧如何影响疼痛和生活方式。 方法:开展了一项组内前后对照研究(工作坊开始至结束),比较疼痛、幸福感、药物使用、生活质量和自尊。进行了调查以深入了解更多定性方面的情况并确定改进之处。该工作坊包括心理教育行动以及针对疼痛和情绪的心理控制训练,基于患者积极参与其疾病管理,促进自我护理和自尊,旨在改善幸福感和生活质量。它由5节时长为3小时的课程组成(每周1节);课程具有小组互动和实践性质。使用SPSS 27.0进行统计分析。为比较相关测量值(前后),我们使用配对样本的学生t检验和威尔科克森检验,为比较独立组,使用学生t检验和曼 - 惠特尼U检验;对于定性变量,我们使用卡方检验和费舍尔检验。 结果:评估了4个工作坊,共有63名患者参与,平均年龄为57.6(标准差:11.37)岁,其中60名(95.2%)为女性。工作坊结束时,疼痛中位数下降了1.5(-2.0 - 0),幸福感提高了2.0(0 - 2.0);生活质量中位数提高了0.121(标准差:0.209),健康状况提高了16.8(23.78),自尊提高了2.74(4.73);[p < 0.001]。最受好评的技巧是冥想,主要是心理镇痛、对着镜子肯定自己和自尊技巧。 结论:对该工作坊的总体满意度为十分制中的9.8分。在疼痛控制、生活质量、健康状况的自我认知、幸福感和自尊方面都有改善。
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