Rassu Fenan S, Staguhn Elena, Ravyts Scott, Castillo Renan, Wiechman Shelley A, Kirkhart Tricia, Aaron Rachel V, Acton Amy, Ware Linda, Milner Stephen M, Price Leigh Ann, Fauerbach James A, Haythornthwaite Jennifer A, Wegener Stephen T
Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Burns. 2025 Mar;51(2):107336. doi: 10.1016/j.burns.2024.107336. Epub 2024 Dec 3.
This randomized controlled trial investigated the effectiveness of an online self-management program, "Take Charge of Burn Pain (TCBP)," for 96 individuals living with chronic burn pain. Participants were randomly assigned to either the 7-week TCBP program integrating cognitive-behavioral therapy techniques, pain education, and self-management strategies or an attention control group focused on general burn recovery information. Assessments conducted at baseline, post-treatment, and 2- and 5-month follow-ups included measures of pain severity, pain interference, pain self-efficacy, posttraumatic stress disorder symptoms, and depression. Compared to the control group, participants in the TCBP program demonstrated greater reductions in pain severity (mean difference: -1.24, 95 % CI: -1.93 to -0.55, p = 0.0007) and pain catastrophizing (mean difference: -5.41, 95 % CI: -10.33 to -0.49, p = 0.0318) post-treatment when adjusting for key variables. At the two-month follow-up, the TCBP group showed significant improvements in pain interference (P = 0.0123), self-efficacy (P = 0.0269), functional abilities (P = 0.0014), and social role participation (P = 0.0498) compared to the control group. Treatment effects were not sustained at 5-month follow-up. Participants in both groups reported high levels of satisfaction with the online intervention, with the majority finding the program helpful and easy to use, and being willing to recommend it to others with pain. Findings suggest preliminary support for short-term benefits of TCBP for managing certain facets of chronic burn pain. This underscores the need to refine digital approaches to maintain and promote long-term improvements. The potential of self-guided online psychological interventions to enhance pain coping strategies for burn survivors persists.
这项随机对照试验调查了名为“掌控烧伤疼痛（TCBP）”的在线自我管理项目对96名患有慢性烧伤疼痛患者的有效性。参与者被随机分配到为期7周的整合认知行为疗法技术、疼痛教育和自我管理策略的TCBP项目组，或专注于一般烧伤恢复信息的注意力控制组。在基线、治疗后以及2个月和5个月随访时进行的评估包括疼痛严重程度、疼痛干扰、疼痛自我效能感、创伤后应激障碍症状和抑郁的测量。与对照组相比，在调整关键变量后，TCBP项目组的参与者在治疗后疼痛严重程度（平均差异：-1.24，95%置信区间：-1.93至-0.55，p = 0.0007）和疼痛灾难化（平均差异：-5.41，95%置信区间：-10.33至-0.49，p = 0.0318）方面有更大程度的降低。在两个月的随访中，与对照组相比，TCBP组在疼痛干扰（P = 0.0123）、自我效能感（P = 0.0269）、功能能力（P = 0.0014）和社会角色参与（P = 0.0498）方面有显著改善。在5个月随访时治疗效果未持续。两组参与者都对在线干预表示高度满意，大多数人认为该项目有帮助且易于使用，并愿意向其他疼痛患者推荐。研究结果为TCBP在管理慢性烧伤疼痛某些方面的短期益处提供了初步支持。这突出了改进数字方法以维持和促进长期改善的必要性。自我引导的在线心理干预增强烧伤幸存者疼痛应对策略的潜力依然存在。
