Cognitive-behaviour therapy for the management of sickle cell disease pain: An evaluation of a community-based intervention
Cognitive-behaviour therapy for the management of sickle cell disease pain: An evaluation of a community-based intervention
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DOI：
10.1348/135910799168588
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发表时间：
1999-09-01
影响因子：
7.9
通讯作者：
Milligan, P
中科院分区：
文献类型：
--
作者：
Thomas, VJ;Dixon, AL;Milligan, P
目标。评估认知-行为团体疗法干预治疗镰状细胞病SCD疼痛的即时效果。设计。这项对照试验。本研究采用纵向、多中心、随机的研究方法。从伦敦七家医院招募的97名SCD患者在获得书面同意后被随机分配到三种治疗条件中的一种：CBT疼痛管理组、注意安慰剂组和不干预对照组。所有参与者在基线和干预后完成了一系列测量，以评估心理健康、疼痛和应对。结果给出了59名符合研究进入标准的参与者，他们参加了选择完成治疗的截止点以上的治疗小组会议，并完成了基线和干预后评估。在使用Kruskal-Wallis检验的几乎所有心理测量中，干预后治疗组对CBT干预的支持程度存在显著差异。随着时间的推移，大多数措施的CHE CBT条件在组内也有显著差异。在确定基线测量中的i：entre差异后，对每个心理测量的排序数据进行以排序的基线分数为协变量的以中心和条件为中心的双向方差分析。对调整后均值的观察表明，干预后的影响大部分由中心1和中心2解释，中心4的影响最小，中心3的一些措施显示出与预测相反的效果。总体而言，所采用的认知-行为方法似乎对SCD疼痛的管理立即有效；在减少心理痛苦和疼痛以及改善应对方面。对目前正在收集的纵向和成本效益数据的进一步分析将表明是否要获得长期和财政利益。
Objectives. To evaluate the immediate effectiveness of a cognitive-behavioural group therapy intervention for the management of sickle cell disease SCD pain. Design. This controlled trial. This study is taken from an ongoing longitudinal, multi-centred, randomizedMethod. Ninety-seven patients with SCD recruited from seven London hospitals were randomly allocated to one of three treatment conditions after giving written consent: a CBT pain management group, an attention placebo group and a no-intervention control. All participants completed a number of measures at baseline and post-intervention to assess psychological well-being, pain and coping.Results. Results are presented for the 59 participants who met the study entrance criteria, attended treatment group sessions above the cur-off point selected for treatment completion, and completed sessions both baseline and post-intervention assessments. Significant post-intervention treatment group differences in favour of the CBT intervention were identified for nearly all of the psychological measures using the Kruskal-Wallis test. Within-group significant differences over time were also found for che CBT condition for the majority of the measures. Following the identification of I:entre differences in baseline measures, two-way ANCOVAs were conducted with centre and condition for the ranked data of each psychological measure using ranked baseline scores as covariates. Observation of the adjusted means indicated that most of the post-intervention effect was accounted for by centres 1 and 2, with centre 4 having a minimal effect and, for centre 3, some of the measures showing a reverse effect to that predicted.Conclusions. Overall, the cognitive-behavioural approach employed appears to be Immediately effective for the management of SCD pain;in terms of reducing psychological distress and pain, and improving coping. Further analysis of longitudinal and cost-effectiveness data currently being collared will indicate whether long-term and financial benefits are to be gained.