Patients' Impression of Change Following Treatment for Chronic Pain: Global, Specific, a Single Dimension, or Many?
Patients' Impression of Change Following Treatment for Chronic Pain: Global, Specific, a Single Dimension, or Many?
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DOI：
10.1016/j.jpain.2015.02.007
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发表时间：
2015-06-01
期刊：
影响因子：
4
通讯作者：
McCracken, Lance M.
中科院分区：
文献类型：
--
作者：
Scott, Whitney;McCracken, Lance M.
患者总体印象变化（PGIC）测量经常被用作慢性疼痛治疗中有意义变化的指标。然而，有限的研究已经检查了PGIC项目的有效性，尽管它们在疼痛的临床试验中被广泛采用。此外，研究尚未检查基于心理的疼痛治疗后PGIC评级的预测因素。本研究的目的是检查的有效性，因素结构，和预测的PGIC评级后，跨学科的心理为基础的治疗慢性疼痛。慢性疼痛患者（N = 476）根据接受和承诺治疗的原则，在4周治疗计划前后完成了疼痛、日常功能和抑郁的标准评估。在该计划之后，患者对1个项目进行评分，以评估他们对整体变化的印象，并对几个项目进行评分，以评估他们对更具体变化的印象：身体和社会功能，工作相关活动，情绪和疼痛。结果表明，全球和具体的变化项目的印象代表一个单一的组成部分。在接受和承诺治疗为基础的治疗研究的背景下，整体PGIC评级似乎在更大程度上受患者的身体活动和情绪的改善，而不是疼痛的改善。研究结果表明，除了一个单一的整体PGIC评级，特定领域的项目可能是相关的一些治疗trials.Perspective：本文报告的有效性和预测因素的患者的印象改变评级后，跨学科的心理为基础的治疗疼痛。除了单一的总体PGIC评级外，临床医生和研究人员根据治疗重点考虑特定领域的项目可能很重要。(C)2015年美国疼痛协会American Pain Society
The Patient Global Impression of Change (PGIC) measure has frequently been used as an indicator of meaningful change in treatments for chronic pain. However, limited research has examined the validity of PGIC items despite their wide adoption in clinical trials for pain. Additionally, research has not yet examined predictors of PGIC ratings following psychologically based treatment for pain. The purpose of the present study was to examine the validity, factor structure, and predictors of PGIC ratings following an interdisciplinary psychologically based treatment for chronic pain. Patients with chronic pain (N = 476) completed standard assessments of pain, daily functioning, and depression before and after a 4-week treatment program based on the principles of acceptance and commitment therapy. Following the program, patients rated 1 item assessing their impression of change overall and several items assessing their impression of more specific changes: physical and social functioning, work-related activities, mood, and pain. Results indicated that the global and specific impression of change items represent a single component. In the context of the acceptance and commitment therapy based treatment studied here, overall PGIC ratings appeared to be influenced to a greater degree by patients' experienced improvements in physical activities and mood than by improvements in pain. The findings suggest that in addition to a single overall PGIC rating, domain-specific items may be relevant for some treatment trials.Perspective: This article reports on the validity and predictors of patients' impression of change ratings following interdisciplinary psychologically based treatment for pain. In addition to a single overall PGIC rating, domain-specific items may be important for clinicians and researchers to consider depending on the focus of treatment. (C) 2015 by the American Pain Society