From Catastrophizing to Recovery: a pilot study of a single-session treatment for pain catastrophizing.
From Catastrophizing to Recovery: a pilot study of a single-session treatment for pain catastrophizing.
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DOI：
10.2147/jpr.s62329
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发表时间：
2014
影响因子：
2.7
通讯作者：
Mackey SC
中科院分区：
文献类型：
--
作者：
Darnall BD;Sturgeon JA;Kao MC;Hah JM;Mackey SC
疼痛灾难化（PC）-对真实的或预期的疼痛的负面认知情绪反应模式-维持慢性疼痛并破坏药物治疗。标准的PC治疗包括多个认知行为治疗疗程。为了提供有效的治疗，我们开发了一个单一的会议，2小时的课程，专门治疗PC题为“从灾难到恢复”[FCR]。确定1）FCR的可行性; 2）参与者对可接受性、可理解性、满意度和使用所学信息的可能性的评分; 3）FCR减少PC的初步疗效。非对照前瞻性初步试验，包括回顾性图表和数据库审查部分。在门诊疼痛诊所（斯坦福大学疼痛管理中心）接受治疗的76名患者参加了免费治疗课程，70名与会者完成并在课后立即返回匿名调查。疼痛灾难化量表（PCS）在班级登记（基线）和治疗后2周和4周进行。使用受试者内重复测量方差分析（ANOVA）和Student t检验对比来比较各时间点的评分。完成基线PCS的所有参与者均被纳入研究参与者（N=57; F=82%;平均年龄=50.2岁）;第2周时有46名参与者完成PCS，第4周时有35名参与者完成PCS。参与者在两个时间点的PC均显著降低（P<0.001），并且发现了较大的效应量（Cohen's d=0.85和d=1.15）。初步数据表明，FCR是一种可接受的有效治疗PC。需要进行更长时间的大型对照研究，以确定反应的持久性，导致反应的因素以及对疼痛，功能和生活质量的影响。
Pain catastrophizing (PC) – a pattern of negative cognitive-emotional responses to real or anticipated pain – maintains chronic pain and undermines medical treatments. Standard PC treatment involves multiple sessions of cognitive behavioral therapy. To provide efficient treatment, we developed a single-session, 2-hour class that solely treats PC entitled “From Catastrophizing to Recovery” [FCR]. To determine 1) feasibility of FCR; 2) participant ratings for acceptability, understandability, satisfaction, and likelihood to use the information learned; and 3) preliminary efficacy of FCR for reducing PC. Uncontrolled prospective pilot trial with a retrospective chart and database review component. Seventy-six patients receiving care at an outpatient pain clinic (the Stanford Pain Management Center) attended the class as free treatment and 70 attendees completed and returned an anonymous survey immediately post-class. The Pain Catastrophizing Scale (PCS) was administered at class check-in (baseline) and at 2, and 4 weeks post-treatment. Within subjects repeated measures analysis of variance (ANOVA) with Student’s t-test contrasts were used to compare scores across time points. All attendees who completed a baseline PCS were included as study participants (N=57; F=82%; mean age =50.2 years); PCS was completed by 46 participants at week 2 and 35 participants at week 4. Participants had significantly reduced PC at both time points (P<0001) and large effect sizes were found (Cohen’s d=0.85 and d=1.15). Preliminary data suggest that FCR is an acceptable and effective treatment for PC. Larger, controlled studies of longer duration are needed to determine durability of response, factors contributing to response, and the impact on pain, function and quality of life.