Telephone Cognitive Behavior Therapy for OEF Veterans with Pain

为患有疼痛的 OEF 退伍军人提供电话认知行为治疗

• 批准号: 8926410
• 负责人: TIMOTHY P CARMODY
• 金额: --
• 依托单位: VETERANS AFFAIRS MED CTR SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-10-01 至 2013-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8926410
• 关键词: Aftercare; Ambulatory Care Facilities; Behavioral Model; Clinic; Cognitive; Cognitive Therapy; Communities; Coping Skills; Dropout; Education; Effectiveness; Enrollment; Epidemic; Functional disorder; Individual; Inflammation; Intervention; Measures; Mediating; Medical center; Methodology; Muscle strain; Nerve; Neuraxis; Outcome; Outcome Measure; Pain; Pain Disorder; Pain management; Patients; Primary Health Care; Procedures; Public Health; Quality of life; Randomized; Randomized Clinical Trials; Recruitment Activity; Reporting; Rosa; Sample Size; Sampling Studies; San Francisco; Schedule; Symptoms; Tail; Telephone; Testing; Time; Trauma; Treatment outcome; United States; Veterans; arm; base; chronic pain; clinical care; coping; emotional distress; follow-up; improved; primary care setting; programs; psychologic; psychosocial; trial comparing

DESCRIPTION (provided by applicant): Although there is growing empirical evidence that cognitive behavior therapy aimed at improving coping skills is beneficial for individuals who suffer from chronic pain, access to these interventions is often limited. Chronic pain is highly prevalent in OEF/OIF veterans. The primary aim of this study will be to test the effectiveness of telephone- delivered cognitive-behavior therapy in the management of chronic pain among post- deployment veterans with chronic pain. A secondary aim will be to determine mechanisms by which this intervention facilitates pain management and successful adjustment of OEF/OIF veterans to chronic pain. The major hypothesis is that patients who receive telephone-delivered cognitive-behavior therapy will show significant improvements in pain-related coping skills, reduced emotional distress, and increased quality of life compared with those who receive telephone-delivered pain education. To achieve these aims, a two-arm randomized clinical trial will be conducted with 150 individuals who suffer from chronic pain, recruited from primary care clinics at the VA Medical Center in San Francisco and affiliated VA Community-based Outpatient Clinics in San Bruno, Santa Rosa, Ukiah, and Eureka. Currently enrolled patients with pain disorders involving muscle strain and inflammation, trauma to nerves, or central nervous system dysfunction will be invited to participate. In Study Arm 1, patients will receive telephone-delivered cognitive behavior therapy (T-CBT); and in Study Arm 2, patients will receive telephone-delivered pain education (T-EDU) matched with Study Arm 1 for amount of contact time. Patients in both groups will receive 12 sessions of telephone- delivered individual therapy over a 20-week period. Pain management outcomes will be measured at 10 weeks (mid-treatment), 20 weeks (post-treatment), 32 weeks (3-month follow-up), and 46 weeks (6-month follow-up). Outcome variables will include measures of pain symptoms, level of functioning, coping, and emotional distress. The sample size will provide greater than 80% power to detect significant differences between groups, at a two-tailed alpha of 0.05. The study hypothesis, assessment methodology, and intervention procedures are based on the cognitive-behavioral model of chronic pain.

描述(由申请人提供)： 尽管越来越多的经验证据表明，旨在改善应对技能的认知行为疗法对患有慢性疼痛的个人是有益的，但获得这些干预措施的机会往往有限。慢性疼痛在OEF/OIF退伍军人中非常普遍。这项研究的主要目的将是测试电话传递的认知行为疗法在患有慢性疼痛的部署后退伍军人中管理慢性疼痛的有效性。第二个目标将是确定这种干预措施促进疼痛管理和成功调整OEF/OIF退伍军人适应慢性疼痛的机制。主要的假设是，与接受电话传递的疼痛教育的患者相比，接受电话传递的认知行为疗法的患者将在与疼痛相关的应对技能、减少情绪困扰和提高生活质量方面显示出显著的改善。为了实现这些目标，将对150名慢性疼痛患者进行双臂随机临床试验，这些患者来自旧金山退伍军人医疗中心的初级保健诊所以及圣布鲁诺、圣罗莎、尤基亚和尤里卡的附属退伍军人管理局社区门诊诊所。目前登记的疼痛障碍患者包括肌肉拉伤和炎症、神经损伤或中枢神经系统功能障碍，将被邀请参加。在研究组1中，患者将接受电话传递的认知行为疗法(T-CBT)；在研究组2中，患者将接受与研究组1在接触时间方面相匹配的电话传递的疼痛教育(T-EDU)。两组患者都将在20周内接受12次电话个体化治疗。疼痛控制结果将在10周(治疗中期)、20周(治疗后)、32周(3个月随访)和46周(6个月随访)进行评估。结果变量将包括疼痛症状、功能水平、应对和情绪困扰的衡量标准。样本大小将提供大于80%的力量来检测组之间的显著差异，双尾阿尔法为0.05。研究假设、评估方法和干预程序均基于慢性疼痛的认知-行为模型。