An online self-help CBT intervention for chronic lower back pain.
An online self-help CBT intervention for chronic lower back pain.
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DOI：
10.1097/ajp.0b013e31822363db
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发表时间：
2012-01
期刊：
影响因子：
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通讯作者：
Stoelb B
中科院分区：
文献类型：
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作者：
Carpenter KM;Stoner SA;Mundt JM;Stoelb B
目的研究表明认知和行为疗法可以有效改善慢性疼痛患者的生活质量。不幸的是，许多患者无法获得认知和行为治疗。我们开发了交互式在线干预的试点版本，以教授慢性腰痛的自我管理技能，慢性腰痛是残疾和缺勤的主要原因。这项随机对照试验的目的是评估其疗效。方法通过互联网招募患有慢性腰痛的个体，通过电话进行筛选，并随机分配接受干预措施（健康工作手册；WW），要么立即（干预组）要么在延迟 3 周后（等待名单对照）。参与者（n = 141，83% 为女性，23% 为少数族裔）被要求在 3 周内完成 WW。在基线、第 3 周和第 6 周完成疼痛、残疾、残疾态度和信念、疼痛控制自我效能和情绪调节的自我报告测量。结果控制结果测量中的基线个体差异，协方差的多变量分析显示，在第 3 周，干预组在所有结果（包括疼痛严重程度评级）上的得分均优于等待列表对照组。在第 6 周，两组都接触过 WW 后，组间没有差异。讨论 使用这种试点干预措施似乎对许多与疼痛相关的结果（包括残疾）产生了积极影响。未来的研究将评估已完成干预措施的有效性，特别关注生活质量和残疾。
ObjectivesResearch has shown that cognitive and behavioral therapies can effectively improve quality of life in chronic pain patients. Unfortunately, many patients lack access to cognitive and behavioral therapy treatments. We developed a pilot version of an interactive online intervention to teach self-management skills for chronic lower back pain, a leading cause of disability and work absenteeism. The objective of this randomized, controlled trial was to evaluate its efficacy.MethodsIndividuals with chronic lower back pain were recruited over the Internet, screened by phone, and randomly assigned to receive access to the intervention (Wellness Workbook; WW) either immediately (intervention group) or after a 3-week delay (wait-list control). Participants (n= 141, 83% female, 23% minority) were asked to complete the WW over 3 weeks. Self-report measures of pain, disability, disabling attitudes and beliefs, self-efficacy for pain control, and mood regulation were completed at baseline, week 3, and week 6.ResultsControlling for baseline individual differences in the outcome measures, multivariate analysis of covariance revealed that, at week 3, the intervention group scored better than the wait-list control group on all outcomes, including pain severity ratings. At week 6, after both groups had been exposed to the WW, there were no differences between groups.DiscussionUse of this pilot intervention seems to have had positive effects on a number of pain-related outcomes, including disability. Future research will evaluate the effectiveness of the completed intervention, with particular attention to quality of life and disability.