Developing and testing a multicomponent breathwork intervention for people with chronic pain

项目摘要(30行) 项目摘要/摘要：K01职业发展奖将为Pratscher博士提供指导培训经验，以加速他向独立的过渡，成为一名研究慢性疼痛、整体健康和情绪健康的补充和综合方法的富有成效的研究人员。慢性疼痛是人类痛苦的主要来源，而慢性下腰痛(CLBP)是最常见、最昂贵和最沉重的疼痛状况之一。疼痛是一种感觉和情感体验，而心理社会因素，如情绪困扰(如抑郁)、应激性生活事件(如创伤)和未表达的情绪(如愤怒)，在很大程度上促成了疼痛的持久性。迫切需要综合治疗，以解决慢性疼痛的这种复杂性，并提供显著和持久的疼痛缓解。呼吸干预(即治疗性呼吸练习)是很有希望的治疗方法，因为它们包含了我们最完整的生理过程之一--呼吸，以同时解决慢性疼痛的身体和情感原因和后果。因此，这项研究的目的是：1)开发和改进一种多组分的呼吸系统干预(源自引导呼吸正念疗法)；2)反复评估其在慢性下腰痛患者中的可行性和可接受性。具体地说，我们将修改治疗手册，以指导干预会议，并调整治疗忠诚度评估，以评估治疗师的能力和对手册的遵守情况。然后，我们将进行为期8周、单独提供的干预的三次单臂重复，随后进行试点随机对照试验，比较最精细版本的干预与常规护理。每次迭代完成后，我们将收集定量和定性数据，并在继续下一次迭代之前与专家小组会面，讨论对干预措施或方案的可能修改。这项工作将产生一种改进的、可重复的多组分呼吸法干预，可以在未来的研究中测试其有效性，候选人计划在此次获奖期间编写一份R级应用程序。佛罗里达大学拥有蓬勃发展的临床疼痛研究环境，这将支持候选人完成拟议的研究和职业发展计划。除了几项培训活动(例如研讨会、会议、独立研究)外，来自一支优秀指导团队的指导将使Pratscher博士能够实现以下目标：(1)为慢性疼痛研究奠定基础，重点关注生物-心理-社会治疗因素；(2)获得干预措施制定、完善和测试过程中的专业技能；以及(3)提高临床试验设计和实施的熟练程度，以发展成为一名成功的独立首席研究员。通过完成拟议的项目和培训活动，Pratscher博士将成为慢性疼痛和整体健康呼吸干预领域的独立科学家和领导者。

Project Summary (30 lines) Project Summary/Abstract: This K01 career development award will provide Dr. Pratscher mentored training experiences that will accelerate his transition to independence as a productive researcher investigating complementary and integrative approaches for chronic pain, whole person health, and emotional well-being. Chronic pain is a major source of human suffering, and chronic low back pain (cLBP) is one of the most common, costly, and burdensome pain conditions. Pain is a sensory and affective experience, and psychosocial factors, such as emotional distress (e.g., depression), stressful life events (e.g., trauma), and unexpressed emotions (e.g., anger), contribute substantially to the persistence of pain. There is an urgent need for integrative treatments that address this complexity of chronic pain and provide significant and lasting pain relief. Breathwork interventions (i.e., therapeutic breathing practices) are promising treatments because they incorporate one of our most integrated physiological processes, respiration, to simultaneously address both physical and emotional causes and consequences of chronic pain. Therefore, the aims of the proposed research are to 1) develop and refine a multicomponent breathwork intervention (derived from Guided Respiration Mindfulness Therapy) and to 2) iteratively evaluate its feasibility and acceptability in people with cLBP. Specifically, we will modify a treatment manual to guide intervention sessions and adapt treatment fidelity evaluations to assess therapist competence and adherence to the manual. Then, we will conduct three single-arm iterations of the 8-week, individually delivered intervention, followed by a pilot randomized controlled trial comparing the most refined version of the intervention to usual care. Upon completion of each iteration, we will gather quantitative and qualitative data and meet with a panel of experts to discuss possible modifications to the intervention or protocol before proceeding with the next iteration. This work will result in a refined and reproducible multicomponent breathwork intervention that can be tested for efficacy in future research, which the candidate plans to pursue with an R-level application written during this award period. The University of Florida has a thriving clinical pain research environment that will support the candidate in completing the proposed research and career development plan. Guidance from an excellent mentoring team in addition to several training activities (e.g., seminars, conferences, independent study) will allow Dr. Pratscher to accomplish the following objectives: (1) build a foundation of knowledge in chronic pain research with emphases on biopsychosocial treatment factors; (2) obtain expertise in the processes of intervention development, refinement, and testing; and (3) enhance proficiency in the design and conduct of clinical trials to develop into a successful independent principal investigator. By completing the proposed project and training activities, Dr. Pratscher will become an independent scientist and leader in the field of breathwork interventions for chronic pain and whole person health.