Further Examination of the Pain Stages of Change Questionnaires Among Chronic Low Back Pain Patients: Long-Term Predictive Validity of Pretreatment and Posttreatment Change Scores and Stability of Posttreatment Scores.
Further Examination of the Pain Stages of Change Questionnaires Among Chronic Low Back Pain Patients: Long-Term Predictive Validity of Pretreatment and Posttreatment Change Scores and Stability of Posttreatment Scores.
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慢性腰痛患者疼痛阶段变化问卷的进一步检查：治疗前和治疗后变化评分的长期预测有效性以及治疗后评分的稳定性。
DOI：
10.1097/ajp.0000000000000796
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Kerns,RobertD
中科院分区：
文献类型：
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作者：
Mun,ChungJung;Otis,JohnD;Concato,John;Reid,MCarringotn;Burg,MatthewM;Czlapinski,Rebecca;Kerns,RobertD
为了最大限度地提高认知行为疗法（CBT）对慢性疼痛的治疗效果，需要激励个体采取自我管理的方法。疼痛变化阶段问卷（PSOCQ）的开发是为了衡量患者对慢性疼痛采取自我管理方法的准备程度。本研究探讨是否治疗前和治疗后的PSOCQ变化评分慢性下腰痛患者可以预测6个月和12个月的随访结果，以及治疗后的PSOCQ评分在follow-up.MethodsParticipants招募从VA初级保健诊所的稳定性。来自60名被分配到常规CBT或改良CBT（即，PRIME CBT）条件进行了分析。自我报告的措施，包括PSOCQ，疼痛的严重程度，残疾，抑郁症状的严重程度，在治疗前，治疗后10周，6个月随访，和12个月的随访assessment.ResultsMultiple回归分析显示，治疗前和治疗后的行动/维持评分的变化显着预测疼痛的严重程度在6个月，而预期前评分的变化显著预测了6个月时的残疾。没有PSOCQ变化评分显着预测抑郁症状的严重程度。治疗后的沉思前和行动/维护分数是相当稳定的，即使在12个月的follow up.ConclusionsChanges患者的态度采取疼痛自我管理的方法可能作为治疗机制之一，并预测长期功能。这项研究还表明，随着时间的推移，对慢性疼痛自我管理的态度变化仍然相当稳定。在治疗过程中采用与慢性疼痛自我管理一致的信念可能会促进持续的益处。
ObjectivesIn order to maximize the therapeutic benefits of cognitive behavioral therapy (CBT) for chronic pain, individuals need to be motivated to adopt a self-management approach. The Pain Stages of Change Questionnaire (PSOCQ) was developed to measure patients’ readiness to adopt a self-management approach to chronic pain. The present study examined whether pre- and post-treatment PSOCQ change scores among chronic low back pain patients could predict six and twelve-month follow-up outcomes, and the stability of post-treatment PSOCQ scores during follow-up.MethodsParticipants were recruited from a VA primary care clinic. Data from 60 participants assigned to either regular CBT or a modified CBT (i.e., PRIME CBT) condition were analyzed in the present study. Self-report measures including PSOCQ, pain severity, disability, and depressive symptom severity were administered at pre-treatment, 10 weeks post-treatment, 6-month follow-up, and 12-month follow-up assessments.ResultsMultiple regression analyses showed that pre- and post-treatment changes in the Action/Maintenance scores significantly predicted pain severity at 6 months, and changes in the Precontemplation scores significantly predicted disability at 6 months. None of the PSOCQ change scores significantly predicted depressive symptom severity. Post-treatment Pre-contemplation and Action/Maintenance scores were quite stable, even at 12-month follow up.ConclusionsChanges in patients’ attitudes toward adopting a pain self-management approach may serve as one of the therapeutic mechanisms and predict long-term function. This study also revealed that changed attitudes toward chronic pain self-management remain quite stable over time. Adoption of beliefs consistent with chronic pain self-management during treatment may promote sustained benefits.