The durability of cognitive behavioral therapy for insomnia in patients with chronic pain.
The durability of cognitive behavioral therapy for insomnia in patients with chronic pain.
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DOI：
10.1155/2012/679648
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发表时间：
2012-01-01
期刊：
影响因子：
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通讯作者：
Perlis, Michael L
中科院分区：
文献类型：
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作者：
Jungquist, Carla R;Tra, Yolande;Perlis, Michael L
本研究的目的是评估认知行为疗法(CBT-I)对慢性疼痛患者的长期(6个月)疗效。治疗前后效果的结果此前已有报道。治疗由一名高级执业护士在研究环境中进行，采用接触/测量对照条件下的CBT-I平行分组、随机、单盲试验。结果包括睡眠日记、失眠严重程度指数、多维疼痛问卷、贝克抑郁问卷、情绪状态简表和疼痛残疾指数。测量时间点分别为治疗结束、治疗后3个月和6个月。接受CBT-I治疗的受试者(n=19)与对照组(n=9)相比，在治疗结束后的睡眠、疼痛、情绪或功能指标上没有表现出任何显著的分组访视效应。然而，在治疗后的6个月中，治疗组的受试者在统计上(P=0.03)和临床上显著改善了总睡眠时间(23分钟)。在本研究中，针对改善失眠的认知行为疗法被成功地应用于中重度慢性疼痛患者，尽管存在持续的中重度疼痛，但CBT-I的积极效果仍在继续改善。
The purpose of this study was to assess the long-term (six months) effects of cognitive behavioral therapy for insomnia (CBT-I) in patients with chronic pain. The results of the pre-post treatment effects have been reported previously. The therapy was delivered by an advanced practice nurse in a research setting using a parallel-group, randomized, single blind trial of CBT-I with a contact/measurement control condition. Outcomes included sleep diary, the Insomnia Severity Index, the Multidimensional Pain Inventory, the Beck Depression Inventory, the Profile of Mood States-short form, and the Pain Disability Index. Measurement time points were end-of-treatment, three-month and six-month posttherapy. Subjects receiving CBT-I (n = 19), as compared to control subjects (n = 9), did not exhibit any significant group by visit effects on measures of sleep, pain, mood, or function after end of treatment. However, subjects in the treatment group exhibited statistically (P = 0.03) and clinically significant improvement in total sleep time (23 minutes) over the six months following treatment. In this paper, cognitive behavioral therapy directed to improve insomnia was successfully delivered to patients with moderate-to-severe chronic pain and the positive effects of CBT-I continued to improve despite the presence of continued moderate-to-severe pain.