Examining Factors of Phantom Limb Pain through Person-Centered Assessment

项目总结 截肢后幻肢疼痛是常见的，但导致这种疼痛的机制和相关因素 疼痛仍不清楚。如果不了解相关因素，临床医生很难推荐 有效的疼痛治疗。这项研究的长期目标是更好地了解 幻肢疼痛在个人层面上，以指导有效的，个性化的治疗方法在未来。 本项目的总体目标是确定生态瞬间的可行性和可接受性。 测量导致幻肢疼痛的以人为中心的因素的评估(EMA)方法。EMA是一种 系统调查方法论，以评估个人的实时个人和环境因素 自然环境。假设EMA调查将达到至少80%-75%的保留率 截肢人群的应答率。这一假设将通过两个具体目标进行检验。目标1： 调查截肢患者假肢疼痛的相关因素。这个 实现这一目标的方法将是与截肢患者举行焦点小组会议，讨论他们的 有幻肢疼痛和任何加重或缓解因素的经历。来自焦点小组的数据将 用于完善EMA关于幻肢疼痛致病因素的问题清单。目标2：确定 EMA识别幻肢疼痛因素的可行性和可接受性。实现这一目标的方法将是 使用重复的EMA调查来测量患有幻肢疼痛的个体的幻肢疼痛及其影响因素 实时截肢和在自然环境中截肢。对EMA问题的答复将分析为 探索导致每位参与者幻肢疼痛的因素。这样做的可行性和可接受性 这一群体中的方法将使用招聘率、保留率、应答率和半 对参与者进行有组织的访谈。这项拟议的研究将通过改进 对截肢后幻肢疼痛影响因素的认识及可行性探讨 以及EMA方法在测量这些因素方面的可接受性。这些贡献预计将是 意义重大，因为对患者特定因素的系统识别将指导未来的知情治疗 建议有效的个性化药物治疗幻肢疼痛，解决关键的公共卫生问题 需要。这项研究是全面培训计划的一部分，该计划包括质量方面的高级课程 研究和因果发现数据分析、通过研讨会、网络和 研究传播，以及在研究技能方面的指导培训，以继续申请人的 成为一名独立研究员的轨迹。明尼苏达大学广泛的研究 基础设施，康复科学的多学科博士项目，以及明尼阿波利斯适应性 设计和工程实验室为完成这项研究和培训创造了理想的环境。

PROJECT SUMMARY Phantom limb pain is common after amputation, but the mechanisms and associated factors contributing to this pain remain unclear. Without an understanding of associated factors, it is difficult for clinicians to recommend effective pain treatments. The long-term goal of this research is to better understand contributing factors to phantom limb pain on an individual level to guide effective, personalized treatment approaches in the future. The overall objective of this project is to establish the feasibility and acceptability of the ecological momentary assessment (EMA) method in measuring person-centered factors contributing to phantom limb pain. EMA is a systematic survey methodology to evaluate real-time personal and environmental factors in an individual’s natural environment. The hypothesis is that EMA surveys will achieve at least 80% retention rate and 75% response rate in the amputation population. This hypothesis will be tested through two specific aims. Aim 1: Investigate factors contributing to phantom limb pain among individuals with amputations. The approach for this aim will be to conduct focus group sessions with individuals with amputations to discuss their experiences with phantom limb pain and any aggravating or relieving factors. Data from the focus groups will be used to refine a list of EMA questions on phantom limb pain contributing factors. Aim 2: Determine the feasibility and acceptability of EMA to identify phantom limb pain factors. The approach for this aim will be to use repeated EMA surveys to measure phantom limb pain and its contributing factors in individuals with amputations in real time and in their natural environment. Responses to EMA questions will be analyzed to explore factors that contribute to phantom limb pain in each participant. The feasibility and acceptability of this method in this population will be determined using recruitment rate, retention rate, response rate, and semi- structured interviews with participants. This proposed research will contribute to science through an improved understanding of contributing factors to phantom limb pain after amputation and the establishment of feasibility and acceptability of the EMA method in measuring these factors. These contributions are expected to be significant because the systematic identification of patient-specific factors will guide informed future treatment recommendations for effective, personalized medicine for phantom limb pain, addressing a critical public health need. This research is part of a comprehensive training plan that includes advanced coursework on qualitative research and causal discovery data analysis, professional development through seminars, networking, and research dissemination, and mentored training in the research skills needed to continue the applicant’s trajectory to becoming an independent researcher. The University of Minnesota’s expansive research infrastructure, the multidisciplinary doctoral program in Rehabilitation Science, and the Minneapolis Adaptive Design and Engineering laboratory create an ideal environment for completing this research and training.