Danielsson Lena, Bergvik Svein, Pripp Are Hugo, Kvarstein Gunnvald
Department of Pain Management, Division of Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, Norway.
Department of Clinical Medicine, UiT - the Arctic University of Norway, Tromsø, Norway.
Can J Pain. 2025 Jul 31;9(1):2515106. doi: 10.1080/24740527.2025.2515106. eCollection 2025.
The efficacy of Acceptance and Commitment Therapy (ACT) for chronic pain when provided as weekly sessions, is well documented. In scarcely populated areas, the traveling distance may be a barrier to weekly attendance. This study aimed to test the efficacy of a group-based ACT intervention, clustered into three bouts of three consecutive days, separated by 4 weeks.
A total of 122 patients, recruited from a university hospital pain clinic, were randomized to either a clustered ACT or Treatment As Usual (TAU) provided by the primary health care services. The study had a semi-crossover design. Group effects of ACT versus TAU were assessed 3 months after the start of ACT by using linear mixed models for repeated measures. Outcome measures included pain intensity, health-related quality of life, pain acceptance, catastrophizing, and psychological distress.
A total of 81 patients completed the ACT intervention. No statistically significant effects were observed on the primary outcome variables, pain intensity and health-related quality of life.
Significant group differences in favor of ACT were detected in pain acceptance (modified Cohens d = 0.32), including pain willingness (modified Cohens d = 0.30) and activity engagement (modified Cohen`s d = 0.23). The treatment effect remained at the 6- and 12-month follow-ups with a trend toward improvement.
A group-based ACT for chronic pain clustered into 3-day bouts may strengthen pain acceptance processes, including pain willingness and activity engagement. Reasons why the intervention did not affect pain intensity and health-related quality of life are discussed.
接受与承诺疗法（ACT）以每周一次的形式用于慢性疼痛时，其疗效已有充分记录。在人口稀少的地区，出行距离可能成为每周就诊的障碍。本研究旨在测试一种基于团体的ACT干预措施的疗效，该干预措施分为连续三天的三个疗程，疗程之间间隔4周。
从一家大学医院疼痛诊所招募了122名患者，将其随机分为接受分组ACT干预组或接受初级卫生保健服务提供的常规治疗（TAU）组。该研究采用半交叉设计。在ACT开始3个月后，通过使用重复测量的线性混合模型评估ACT与TAU的组间效应。结局指标包括疼痛强度、健康相关生活质量、疼痛接纳度、灾难化思维和心理困扰。
共有81名患者完成了ACT干预。在主要结局变量疼痛强度和健康相关生活质量方面未观察到统计学上的显著效果。
在疼痛接纳度方面检测到有利于ACT的显著组间差异（修正Cohen's d = 0.32），包括疼痛意愿（修正Cohen's d = 0.30）和活动参与度（修正Cohen's d = 0.23）。在6个月和12个月的随访中，治疗效果依然存在且有改善趋势。
一种分为3天疗程的基于团体的ACT慢性疼痛干预措施可能会加强疼痛接纳过程，包括疼痛意愿和活动参与度。文中讨论了该干预措施未影响疼痛强度和健康相关生活质量的原因。
