Using Intervention Mapping to Develop a Novel Pain Self-Management Intervention for People with Cirrhosis.
Using Intervention Mapping to Develop a Novel Pain Self-Management Intervention for People with Cirrhosis.
复制标题
使用干预映射为肝硬化患者开发新型疼痛自我管理干预措施。
DOI：
10.1007/s10620-022-07380-4
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发表时间：
2022
影响因子：
3.1
通讯作者：
Merlin,Jessica
中科院分区：
文献类型：
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作者：
Rogal,ShariS;Chinman,MatthewJ;DeMonte,William;Gibson,Sandra;Hoyt-Trapp,Stephanie;Klima,GloriaJ;Jonassaint,NaudiaL;Liebschutz,JaneM;Kraemer,KevinL;Merlin,Jessica
背景慢性疼痛在肝硬化患者中很常见，治疗起来也很困难。虽然有希望，但疼痛自我管理（PSM）干预措施并不适合这一人群的需求。目的是为肝硬化患者设计PSM干预措施。方法对来自两个医疗中心的17名肝硬化患者，12名肝病专家和6名管理人员进行了半结构化访谈，结构化干预映射（IM）过程。定性内容分析的指导下，社会认知理论（SCT）和实施研究的综合框架（CFIR），并纳入干预发展。一个规划小组定期举行了整个干预，就如何使用数据和理论，通过IM开发干预达成共识。ResultsParticipants描述了PSM行为的障碍，包括缺乏简单的，以证据为基础的干预措施，肝硬化患者的疼痛，供应商的知识不足，时间和培训，以及缺乏冠军，资金和沟通。患者描述了使用行为方法治疗疼痛的高动机，包括冥想，祈祷和锻炼。该干预旨在解决肝硬化患者PSM行为的障碍，使用行为改变方法，解决知识，自我效能和结果预期。LEAP（关于疼痛的肝脏教育）干预是一个为期12周的模块化干预，通过电话通过个人和小组会议与健康coachs.ConclusionsPeople肝硬化，肝病学家，和管理员告知这个理论驱动的，量身定制的PSM干预，这是为了在真实的世界中实施。
BackgroundChronic pain is common among patients with cirrhosis and is challenging to treat. While promising, pain self-management (PSM) interventions have not been tailored to this population’s needs.AimsTo design a PSM intervention for patients with cirrhosis.MethodsSemi-structured interviews with 17 patients with cirrhosis, 12 hepatologists, and 6 administrators from two medical centers were conducted to inform a rigorous, structured intervention mapping (IM) process. Qualitative content analysis was guided by social cognitive theory (SCT) and the Consolidated Framework for Implementation Research (CFIR) and incorporated into intervention development. A planning group met regularly throughout the intervention, to reach consensus about how to use data and theory to develop the intervention through IM.ResultsParticipants described barriers to PSM behaviors, including the absence of simple, evidence-based interventions for pain for patients with cirrhosis, inadequate provider knowledge, time, and training, and lack of champions, funding, and communication. Patients described high motivation to treat pain using behavioral methods including meditation, prayer, and exercise. The intervention was designed to address barriers to PSM behaviors for patients with cirrhosis, using behavior change methods that address knowledge, self-efficacy, and outcome expectations. The LEAP (Liver Education About Pain) intervention is a 12-week, modular intervention delivered by phone via individual and group sessions with a health coach.ConclusionsPeople with cirrhosis, hepatologists, and administrators informed this theory-driven, tailored PSM intervention, which was designed to be implementable in the real world.