Coping Skills Training for Spinal Cord Stimulator Patients

慢性下腰痛(CLBP)是500多万美国人残疾的主要来源。 对经济影响的估计从每年500亿美元到1000亿美元不等。规模的大小 这些患者的心理痛苦和残疾是不可估量的。脊髓刺激器 (SCS)种植手术代表着患者治疗的重要进步 患有慢性支气管炎。SCS植入物正变得越来越普遍，有数万人 每年植入的SCSS的数量。不幸的是，干细胞植入的成功率差别很大， 而且大多数患者在手术后将继续经历一定程度的疼痛。 临床观察表明，患者应对这种疼痛的能力差异很大。 这项拟议的研究试图确定围手术期疼痛应对技能培训是否 协议将导致改善疼痛应对和疼痛管理的自我效能，并 减少患者的身体残疾、心理困扰、疼痛和疼痛行为 有接受SCS手术的CLBP。在这项研究中，128名接受SCS的患者 植入物将被随机分配到以下三种情况之一：1)疼痛应对技能培训 植入外科(PCST-IS)，系统地培训患者各种认知和 行为应对技能，旨在提高他们在以下方面的自我效能 应对SCS种植手术带来的具体挑战；2)慢性疼痛教育a 开展慢性腰背痛的性质和治疗教育的对比条件 疼痛；或3)标准护理控制条件。评估措施须在及之前收集 治疗后以及6个月和12个月的随访包括自我效能、疼痛应对、 身体残疾、心理困扰、疼痛和疼痛行为。如果围手术期疼痛应对 技能培训是有效的，它将为进一步应用和 在其他与疼痛相关的外科干预中测试这种治疗方法。以证据为基础的 心理干预对儿童精神分裂症的医疗管理具有重要意义 脊髓刺激器患者。这也可能导致更大程度的心理整合 对接受多项其他手术的患者的标准医疗护理的干预 痛苦的环境。因此，这项研究最终可能导致围手术期应对技能的提高。 可改善患者身体和心理功能的干预措施 患有各种与疼痛相关的疾病。

Chronic low back pain (CLBP) is a major source of disability for more than 5 million Americans. Estimates of the economic impact range from $50 to $100 billion annually. The magnitude of psychological distress and disability in these patients is immeasurable. Spinal cord stimulator (SCS) implantation surgery represents an important advance in the treatment of patients suffering from CLBP. SCS implants are becoming increasingly common, with tens of thousands of SCSs implanted annually. Unfortunately, the success rate of SCS implantation varies widely, and most patients will continue to experience some degree of pain following the procedure. Clinical observations suggest that the ability of patients to cope with this pain is quite varied. The proposed study seeks to determine whether a peri-operative pain coping skills training protocol will lead to improvements in pain coping and self-efficacy for pain management and to reductions in physical disability, psychological distress, pain and pain behavior in patients having CLBP who undergo SCS surgery. In this study, 128 patients who are undergoing SCS implant will be randomly assigned to one of three conditions: 1) Pain coping skills training for implant surgery (PCST-IS) which systematically trains patients in a variety of cognitive and behavioral coping skills designed to increase their self-efficacy with regard to their abilities to address specific challenges posed by SCS implant surgery; 2) Chronic pain education a comparison condition providing education on the nature and treatment of chronic low back pain; or, 3) standard care control condition. Assessment measures to be collected before and after treatment and at 6 and 12 months follow-up include measures of self-efficacy, pain coping, physical disability, psychological distress, pain, and pain behavior. If peri-surgical pain coping skills training is effective, it would lay important groundwork for further application and testing of this treatment in other pain-related surgical interventions. An evidence-based psychological intervention could have significant implications for the medical management of spinal cord stimulator patients. It also could lead to a greater integration of psychological interventions into standard medical care for patients undergoing surgery for a number of other painful conditions. As a result, this research ultimately could lead to peri-surgical coping skills interventions that could improve the physical and psychological functioning of patients suffering from a variety of pain-related conditions.