Coping Skills Training for Spinal Cord Stimulator Patients

慢性腰痛（CLBP）是超过500万美国人的主要残疾来源。 对经济影响的估计为每年500亿至1 000亿美元。的大小 这些病人的心理痛苦和残疾是无法估量的。脊髓刺激器 (SCS)植入手术代表了治疗患者的重要进展 患有CLBP。SCS植入物越来越普遍， 每年植入的SCS数量。不幸的是，SCS植入的成功率差异很大， 并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，患者科普这种疼痛的能力是相当不同的。 这项研究旨在确定围手术期疼痛应对技能培训是否 方案将导致疼痛应对和疼痛管理自我效能的改善， 减少患者的身体残疾、心理困扰、疼痛和疼痛行为 接受SCS手术的CLBP患者。在这项研究中，128名接受SCS的患者 植入物将被随机分配到三种情况之一：1）疼痛应对技能培训， 植入手术（PCST-IS）系统地培训患者各种认知和 行为应对技能，旨在提高他们的自我效能， 解决SCS植入手术带来的具体挑战; 2）慢性疼痛教育， 比较条件提供教育的性质和治疗慢性腰痛 疼痛;或，3）标准护理控制状况。评估措施之前收集， 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，它将为进一步应用奠定重要基础， 在其他与疼痛相关的手术干预中测试这种治疗。循证 心理干预可能会对医疗管理产生重大影响， 脊髓刺激器患者。它也可能导致心理上的更大整合 对接受手术的病人的标准医疗护理进行干预， 痛苦的条件。因此，这项研究最终可能会导致围手术期的应对技巧 可以改善患者生理和心理功能的干预措施 患有各种与疼痛有关的疾病

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.