Fibromyalgia Symptom Reduction by Online Behavioral Self-monitoring, Longitudinal Single Subject Analysis and Automated Delivery of Individualized Guidance.
Fibromyalgia Symptom Reduction by Online Behavioral Self-monitoring, Longitudinal Single Subject Analysis and Automated Delivery of Individualized Guidance.
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DOI：
10.4103/1947-2714.118920
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发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Soltysik R
中科院分区：
文献类型：
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作者：
Collinge W;Yarnold P;Soltysik R
纤维肌痛（FM）是一种复杂的慢性疼痛疾病，很难治疗。目前流行的方法是药物，心理教育和行为策略的整合。信息技术为FM患者提供了系统监测症状以及各种管理策略的潜在影响的巨大潜力。本研究旨在评估基于网络的自我监测和症状管理系统（SMARTLog）的效果，该系统分析个人自我监测数据并随时间推移提供基于数据的反馈。受试者是自我推荐的，匿名的，并通过FM宣传网站上的宣传招募。标准化工具评估健康状况，自我效能，并在基线和每月的控制点参与。鼓励受试者每周完成数次SMARTLog。使用受试者内、单变量和多变量分析来推导每个用户的分类树，将特定行为变量与随时间推移的症状水平相关联。适度使用（每周3次x 3个月）增加了疼痛、记忆力、胃肠道问题、抑郁、疲劳和注意力集中等临床显著改善的可能性;大量使用（每周4.5次x 5个月）产生了上述改善以及僵硬和睡眠困难的改善。个性化的、基于网络的行为自我监测以及个人定制的反馈可以使FM患者随着时间的推移显着降低症状水平。
Fibromyalgia (FM) is a complex chronic pain condition that is difficult to treat. The prevailing approach is an integration of pharmacological, psycho-educational, and behavioral strategies. Information technology offers great potential for FM sufferers to systemically monitor symptoms as well as potential impacts of various management strategies. This study aimed to evaluate effects of a web-based, self-monitoring and symptom management system (SMARTLog) that analyzes personal self-monitoring data and delivers data-based feedback over time. Subjects were self-referred, anonymous, and recruited via publicity on FM advocacy websites. Standardized instruments assessed health status, self-efficacy, and locus of control at baseline and monthly during participation. Subjects were encouraged to complete the SMARTLog several times weekly. Within-subject, univariate, and multivariate analyses were used to derive classification trees for each user associating specific behavior variables with symptom levels over time. Moderate use (3 times weekly x 3 months) increased likelihood of clinically significant improvements in pain, memory, gastrointestinal problems, depression, fatigue, and concentration; heavy use (4.5 times weekly x five months) produced the above plus improvement in stiffness and sleep difficulties. Individualized, web-based behavioral self-monitoring with personally-tailored feedback can enable FM sufferers to significantly reduce symptom levels over time.