Steel Jennifer L, Brintz Carrie E, Heapy Alicia A, Keefe Francis, Cheatle Martin D, Jhamb Manisha, McNeil Daniel W, Shallcross Amanda J, Kimmel Paul L, Dember Laura M, White David M, Williams Joey, Cukor Daniel
Center for Excellence in Behavioral Medicine, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 601, Pittsburgh, PA, 15213, USA.
Quality of Life Program for UPMC's Liver Cancer Center, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 601, Pittsburgh, PA, 15213, USA.
J Behav Med. 2025 Apr;48(2):298-307. doi: 10.1007/s10865-024-00534-x. Epub 2024 Dec 3.
Pain Coping Skills Training (PCST) is a first-line cognitive-behavioral, non-pharmacological treatment for chronic pain and comorbid symptoms. PCST has been shown to be effective in racially and ethnically diverse cohorts across several chronic medical conditions. However, PCST has not been evaluated in those with end stage kidney disease (ESKD) receiving in-center maintenance hemodialysis. Due to the high rates of morbidity associated with ESKD, and time-intensive treatment, an adaptation of PCST was warranted to address the unique challenges experienced by people living with ESKD. Using current guidelines developed by Card and colleagues for intervention adaptation, PCST was adapted so that it could be implemented among people living with ESKD in a national multisite trial. The objective of this paper was to describe the adaption process outlined by Card and colleagues including how the team selected an effective intervention to adapt, developed a program model, identified mismatches in the original intervention and study population, and then adapted the intervention for those with ESKD treated with in-center maintenance hemodialysis. Finally, we briefly describe future directions for clinical practice and research with the adapted PCST intervention for those with ESKD.Trial registration: ClinicalTrials.gov #NCT04571619.
疼痛应对技能训练（PCST）是一种用于慢性疼痛和共病症状的一线认知行为非药物治疗方法。PCST已被证明在多种慢性疾病的不同种族和族裔人群中有效。然而，尚未对接受中心内维持性血液透析的终末期肾病（ESKD）患者进行PCST评估。由于ESKD相关的高发病率以及高强度的治疗，有必要对PCST进行调整，以应对ESKD患者所面临的独特挑战。根据Card及其同事制定的当前干预调整指南，对PCST进行了调整，以便能够在一项全国多中心试验中应用于ESKD患者。本文的目的是描述Card及其同事概述的调整过程，包括团队如何选择一种有效的干预措施进行调整、制定项目模型、识别原始干预措施与研究人群之间的不匹配之处，然后针对接受中心内维持性血液透析治疗的ESKD患者调整干预措施。最后，我们简要描述了针对ESKD患者的适应性PCST干预措施在临床实践和研究方面的未来方向。试验注册：ClinicalTrials.gov #NCT04571619。
