TAILORING COGNITIVE BEHAVIORAL TREATMENT FOR CANCER PAIN

说明(改编自调查人员摘要)： 建议的研究是评估近期和中期的有效性 对癌症疼痛的认知行为治疗(CBT)与 诊断简档，源自生物行为疼痛简档(BPP)。一个 三组实验、重复测量设计比较 采用标准CBT和常规疼痛治疗的特制CBT患者 对照组患者。四个地点的三百名患者将被 随机分配到学习ARM。CBT治疗将包括 认知-行为干预，如教育、引导成像、 与时间相关的互动，注意力转移，认知重组， 和放松。假设在治疗结束时，患者 接受与其BPP匹配的CBT方案的患者将报告较少的疼痛 强度，更少的疼痛行为，对治疗的更大反应， 更持久的反应，更少的疼痛对活动的干扰， 更少的症状困扰，更好的情绪，功能，睡眠和生活质量， 与接受标准的患者相比，个人目标的实现程度更高 CBT还是通常的疼痛治疗，并认为效果是量身定做的 治疗将随着时间的推移而持续。患者将每周接受一次治疗 五周，以基线评估，五周结束，1-和 治疗后6个月使用简明疼痛问卷、症状苦恼 量表、心境状态简介、Katz ADL、SF-36、疼痛病史和人口统计学 表，以及目标及其实现情况的确定。多变量 方差分析将用于比较干预前研究的等价性 重复测量的分组和多变量GLM分析 主要假设。

DESCRIPTION (Adapted from the Investigator's Abstract): The purpose of the proposed research is to evaluate the immediate and mid-range effectiveness of cognitive-behavioral treatment (CBT) for cancer pain matched to a diagnostic profile, derived from the Biobehavioral Pain Profile (BPP). A three-group experimental, repeated measures design will compare profile-tailored CBT patients with standard CBT and usual pain-treatment control group patients. Three hundred patients in four sites will be randomly assigned to study arm. CBT treatment will include cognitive-behavioral interventions such as education, guided-imagery, time-contingent interactions, attention-diversion, cognitive restructuring, and relaxation. It is hypothesized that at the end of treatment, patients who receive a CBT protocol matched to their BPP will report less pain intensity, fewer pain behaviors, greater responsiveness to treatment, greater durability of response, less interference of pain with activities, less symptom distress, better mood, functioning, sleep and quality of life, and greater achievement of personal goals than patients who receive standard CBT or usual pain treatment, and that the effect of the profile-tailored treatment will be sustained over time. Patients will be treated weekly for five weeks with assessment at baseline, end of the five weeks, 1- and 6-months post treatment using the Brief Pain Inventory, Symptom Distress Scale, Profile of Mood States, Katz ADL, SF-36, pain history and demographic sheets, and identification of goals and their achievement. Multivariate ANOVA will be used to compare the pre-intervention equivalence of the study groups and multivariate GLM analysis of repeated measures to test the primary hypothesis.