Reed David E, Palitsky Roman, Engel Charles C, Williams Rhonda M, Kroenke Kurt, Bokhour Barbara G, Zeliadt Steven B
Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA.
Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound, Seattle, WA, USA.
Int J Behav Med. 2024 Sep 12. doi: 10.1007/s12529-024-10320-3.
Co-occurring chronic pain and posttraumatic stress disorder (PTSD) is associated with poorer physical and mental functioning and well-being. Treatments often incorporate goal-setting around personally meaningful behaviors; however, it is unclear whether intentionally focusing on improving meaning and purpose in life (i.e., meaning-as-goal) may also serve as a helpful treatment target. The objective of the current study is to determine whether reported progress toward meaning-as-goal at 6 months is associated with pain severity and interference, physical and mental health functioning, and global meaning and purpose at 6- and 12-months.
Data were collected as part of an evaluation effort focused on VA's Whole Health System implementation efforts. VA electronic health records were linked to survey data across three time points (baseline, 6 months, and 12 months) from Veterans with both chronic pain and PTSD across 18 VA sites. A total of 1341 Veterans met inclusion criteria (mean age = 62, SD = 11.7).
Regression analyses showed that progress toward meaning-as-goal was significantly associated with all 6-month variables, with standardized coefficients ranging from - 0.14 (pain severity and interference) to .37 (global meaning and purpose), in addition to all 12-month variables, with standardized coefficients ranging from - .13 (pain severity and interference) to .31 (global meaning and purpose).
Efforts to intentionally promote meaning and purpose as part of evidence-based treatment for chronic pain and PTSD may lead to decreased pain and improved physical and mental health functioning and global meaning and purpose. With coefficients ranging from small to moderate effect sizes, more work is needed to better understand how best to maximize meaning-related goals.
慢性疼痛与创伤后应激障碍（PTSD）共病与较差的身体和心理功能及幸福感相关。治疗通常围绕个人有意义的行为设定目标；然而，尚不清楚有意专注于提升生活的意义和目的（即意义即目标）是否也可作为一个有益的治疗靶点。本研究的目的是确定在6个月时报告的朝着意义即目标的进展是否与6个月和12个月时的疼痛严重程度及干扰、身心健康功能以及整体意义和目的相关。
作为针对退伍军人事务部（VA）全健康系统实施工作评估的一部分收集数据。VA电子健康记录与来自18个VA站点的患有慢性疼痛和PTSD的退伍军人在三个时间点（基线、6个月和12个月）的调查数据相关联。共有1341名退伍军人符合纳入标准（平均年龄 = 62岁，标准差 = 11.7）。
回归分析表明，朝着意义即目标的进展与所有6个月时的变量显著相关，标准化系数范围从 -0.14（疼痛严重程度和干扰）到0.37（整体意义和目的），此外还与所有12个月时的变量相关，标准化系数范围从 -0.13（疼痛严重程度和干扰）到0.31（整体意义和目的）。
作为慢性疼痛和PTSD循证治疗的一部分，有意促进意义和目的的努力可能会减轻疼痛，改善身心健康功能以及整体意义和目的。由于效应大小系数范围从小到中等，因此需要更多工作来更好地理解如何最好地最大化与意义相关的目标。
