Measure of Body Awareness

描述(由申请人提供)：提高身体意识已被提出为治疗疼痛的一种新的非药理学方法。它被提议作为一种行动机制，从以身心和/或手动疗法为特征的治疗方法中获得健康益处，如瑜伽、太极、按摩、基于正念的疗法和Feldenkrais。这些方法在患有疼痛的患者中越来越受欢迎。这一假说认为，提高身体意识可能有助于疼痛患者，这一假说得到了最近的神经科学发现的支持，需要进行严格的临床研究。然而，身体意识的研究一直受到身体意识结构的模糊和定义不明确的阻碍。在关于焦虑的研究中，身体意识一词被用来描述夸大的患者对身体症状的关注，通常被认为是对疼痛的不适应。心身疗法和徒手疗法声称通过增强一种特定类型的身体意识来改善疼痛，这种意识的特征是非评判性的正念和体验感。患者的注意力是否应该从疼痛中转移开或转移到疼痛上，这一点仍然令人困惑。非常需要研究这些治疗疼痛的方法，但最近完成的一项系统审查得出结论，现有的测量身体意识的工具是不合适的或有限的。我们建议开发一种新的身体感知工具，以更好地了解心理因素与疼痛的复杂相互作用，并开发一种疼痛研究的测量方法，这是心理-身体干预研究和手动治疗所需的。通过以下步骤，我们提炼了身体意识结构，并开发了调查工具：1)与上述治疗方法的提供者和患者组成焦点小组；2)结构精炼和项目收集的定性方法；3)从项目库中组装问卷；4)深入认知测试；5)使用因素分析对疼痛患者(n=250)进行现场测试，以进行最终项目选择；6)检验现场测试数据的内部一致性，对患者样本(n=100)进行重测可靠性。我们在一项单独资助的试验(n=50)和治疗组(n=50)中测试了最终的工具，患者接受身体意识训练，以收集预测和判别有效性的先导数据。这项测量研究将为疼痛研究开发一种工具，这是理解身体意识差异如何影响疼痛轨迹所必需的。它将为疼痛研究提供新的方向，并可能改变与急慢性疼痛治疗相关的传统范式。

DESCRIPTION (provided by applicant): Improving body awareness has been proposed as a novel non-pharmacological approach for the treatment of pain. It has been proposed as a mechanism of action for the health benefits obtained from therapeutic approaches characterized as mind-body and/or manual therapies, such as Yoga, Tai Chi, massage, mindfulness- based therapies, and Feldenkrais. These approaches enjoy a growing popularity among patients with painful condition. The hypothesis, that improving body awareness might help patients with pain, is supported by recent neuroscientific findings and needs to be subjected to rigorous clinical research. The study of body awareness, however, has been hampered by the poor definition and ambiguity of its construct. In studies of anxiety, the term body awareness has been used to describe an exaggerated patient focus on physical symptoms and is mostly seen as maladaptive for pain. Mind-body and manual therapies claim to improve pain by enhancing a particular type of body awareness characterized by non-judgmental mindfulness and a sense of embodiment. Confusion persists as to whether the patient's attention should be distracted away from or directed towards pain. There is great need to study these approaches to the treatment of pain, but a recently completed systematic review concluded that existing instruments measuring body awareness are inappropriate or limited. We propose to develop a new body awareness instrument to better understand the complex interactions of psychological factors with pain and to develop a measurement for pain research that is needed for intervention studies of mind-body and manual therapies. We refine the body awareness construct and develop a survey instrument by the following steps: 1) focus groups with providers and patients of above therapeutic approaches; 2) qualitative methods for construct refinement and item collection; 3) questionnaire assembly from item pool; 4) in-depth cognitive testing; 5) field testing the questionnaire in pain patients (n=250) using factor analysis for final item selection; 6) examine internal consistency in data from field test, test-retest reliability in a patient sample (n=100). We test the final instrument in a separately funded trial (n = 50) and a therapeutic group (n = 50) with patients in body awareness training to collect pilot data for predictive and discriminant validity. This measurement study will develop an instrument for pain research that is needed to understand how differences in body awareness affect the trajectory of pain. It will provide new directions for pain research and may change the conventional paradigms associated with the treatment of acute and chronic pain.