Silva Marcelina Jasmine
The Focus on Opioid Transitions (FOOT Steps) Program, Walnut Creek, CA 94598, USA.
The Focus on Opioid Transitions (FOOT Steps) Program, Capitola, CA 95010, USA.
J Clin Med. 2024 Oct 4;13(19):5923. doi: 10.3390/jcm13195923.
Anxiety-based cognitive distortions pertaining to somatic perception (ABCD-SPs)-primarily catastrophizing, fear avoidance, and kinesiophobia-have been repeatedly linked to worsening chronic, non-cancer pain (CNCP) outcomes of increased disability, amplified pain, ineffective opioid use, and opioid misuse. Several studies have suggested that treating ABCD-SPs can improve pain outcomes, yet identification and targeting of ABCD-SPs are not part of the standard medical pain assessment and treatment plan. Utilizing a narrative review of proposed mechanisms, published patient perspectives, and study correlations connecting these cognitive distortions with CNCP outcomes, an approach for better practice in the delivery of standard medical CNCP care can be deduced and formulated into a Belief and Behavior Action Plan (BBAP) for medical clinicians treating CNCP to implement into initial and maintenance care planning. These recommendations require relatively few resources to implement and have the potential to disseminate more effective CNCP treatment on a large scale now and in the future with the new frontier of cognitive computing in medicine.
与躯体感知相关的基于焦虑的认知扭曲(ABCD-SPs)——主要是灾难化、恐惧回避和运动恐惧症——已多次与慢性非癌性疼痛(CNCP)病情恶化相关,包括残疾加剧、疼痛加剧、阿片类药物使用无效和阿片类药物滥用。多项研究表明,治疗ABCD-SPs可改善疼痛结局,但识别和针对ABCD-SPs并非标准医学疼痛评估和治疗计划的一部分。通过对提出的机制、已发表的患者观点以及将这些认知扭曲与CNCP结局联系起来的研究相关性进行叙述性综述,可以推导出一种在提供标准医学CNCP护理方面更好实践的方法,并将其制定为医疗临床医生治疗CNCP时在初始和维持护理计划中实施的信念与行为行动计划(BBAP)。这些建议实施起来所需资源相对较少,并且随着医学认知计算的新前沿技术出现,有可能在现在和未来大规模推广更有效的CNCP治疗。