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心理社会评估作为综合个性化护理路径的关键组成部分:一项腰痛随机对照试验方案

Psychosocial Assessment as a Key Component in an Integrated, Personalized Care Pathway: A Protocol for a Low Back Pain Randomized Controlled Trial.

作者信息

Anselmo Anna, Pagano Maria, Corallo Francesco, Cappadona Irene, Cardile Davide, Russo Fabrizio, Laudisio Alice, Papalia Giuseppe F, Quartarone Angelo, Calabrò Rocco S

机构信息

IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, S.S. 113, C. da Casazza, 98124, Messina, Italy.

Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Rome, Italy.

出版信息

Pain Ther. 2025 Jun;14(3):1155-1168. doi: 10.1007/s40122-025-00741-7. Epub 2025 Apr 29.

Abstract

INTRODUCTION

Low back pain (LBP) is the primary factor contributing to years lived with disability. In view of the close correlation between the functions of the body, which cannot be examined piecemeal but as an integrated system, a holistic approach allows for a comprehensive assessment of the patient. The main objective of this study is to evaluate the impact of face-to-face or remote rehabilitation treatment on the psychosocial aspects of patients with chronic low back pain (CLBP) examining all possible related dimensions: cognitive function, anxiety and depression, pain perception, treatment adherence, the sexual sphere, family dynamics, social support, dysfunctional communication, quality of life (QoL), while also considering attribution of causes.

METHODS

This prospective, randomized, controlled trial with blinded outcome assessors evaluates the psychosocial functioning of 86 patients with chronic LBP. Participants divided into two groups to compare tele-rehabilitation with face-to-face rehabilitation with a 1:1 randomization based on a web-based system will all undergo neuropsychological, psychological, and associated clinical condition assessment through standardized tests and ad hoc questionnaires at enrollment (T0), after 1 month (T1), 2 months (T2), and 6 months (T3). The analysis involves descriptive statistics, ANOVA, and correlation tests to evaluate treatment effects and psychosocial outcomes at multiple time points.

PLANNED OUTCOMES

We expect this study to provide a comprehensive, in-depth, and integrated understanding of the patient, shedding light on the challenges they may face in managing chronic LBP (CLBP). Repeated administration of the questionnaires will allow us to monitor the patient over time, assess any changes in their health status, and structure an intervention tailored to their needs. By emphasizing these often neglected areas through a comprehensive, multi-step assessment, it will be possible to quantify and analyze how these risk factors can affect patients' wellbeing and hinder the treatment process and recovery.

TRIAL REGISTRATION

Registered on Clinicaltrials.gov (ID: NCT06895317).

摘要

引言

腰痛是导致残疾生存年数的主要因素。鉴于身体各项功能之间存在密切关联,不能逐一检查而应作为一个整体系统来审视,整体方法有助于对患者进行全面评估。本研究的主要目的是评估面对面或远程康复治疗对慢性腰痛(CLBP)患者心理社会方面的影响,考察所有可能相关的维度:认知功能、焦虑和抑郁、疼痛感知、治疗依从性、性方面、家庭动态、社会支持、功能失调的沟通、生活质量(QoL),同时考虑病因归因。

方法

这项前瞻性、随机、对照试验由 blinded outcome assessors 进行评估,纳入了 86 例慢性腰痛患者,评估其心理社会功能。参与者分为两组,基于网络系统以 1:1 的比例随机分配,分别接受远程康复和面对面康复,所有参与者在入组时(T0)、1 个月后(T1)、2 个月后(T2)和 6 个月后(T3),均通过标准化测试和特设问卷进行神经心理学、心理学及相关临床状况评估。分析包括描述性统计、方差分析和相关性检验,以评估多个时间点的治疗效果和心理社会结果。

预期结果

我们期望本研究能对患者提供全面、深入且综合的了解,揭示他们在管理慢性腰痛(CLBP)过程中可能面临的挑战。问卷的重复发放将使我们能够长期监测患者,评估其健康状况的任何变化,并构建符合其需求的干预措施。通过全面、多步骤评估来强调这些常常被忽视的领域,将有可能量化和分析这些风险因素如何影响患者的幸福感,并阻碍治疗进程和康复。

试验注册

已在 Clinicaltrials.gov 上注册(ID:NCT06895317)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8849/12085730/bd276dcc281f/40122_2025_741_Fig1_HTML.jpg

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