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One-day Acceptance and Commitment Therapy workshop for preventing persistent post-surgical pain and dysfunction in
McKenzie K Roddy1, Derrecka M Boykin2, Katherine Hadlandsmyth3
1Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States of America.
Journal of Psychosomatic Research
|September 22, 2020
Summary
This study tested a behavioral intervention to prevent persistent post-surgical pain and improve function after knee replacement surgery. The intervention showed promise in reducing pain and enhancing recovery for veterans.
Area of Science:
- Pain Management
- Behavioral Medicine
- Surgical Outcomes
Background:
- Persistent post-surgical pain is a significant issue impacting patient quality of life and can lead to long-term opioid dependence.
- Effective interventions are needed to mitigate the risk of poor post-surgical outcomes, including chronic pain and functional impairment.
Purpose of the Study:
- To evaluate the effectiveness of a pre-surgical behavioral intervention in preventing persistent post-surgical pain and improving functioning.
- To assess the impact of Acceptance and Commitment Therapy (ACT) on pain intensity, knee function, distress, and coping skills in veterans undergoing total knee arthroplasty (TKA).
Main Methods:
- A randomized, patient- and assessor-blind, attention-controlled clinical trial involving 430 veterans undergoing TKA.
- Participants were assigned to either a one-day Acceptance and Commitment Therapy (ACT) workshop or an education and attention control workshop.
- Assessments of pain, function, distress, and coping skills were conducted at multiple time points up to 6 months post-surgery, with a booster session provided via phone.
Main Results:
- Primary outcomes include pain intensity and knee-specific functioning.
- Secondary outcomes encompass distress symptoms and coping abilities.
- Mediation analyses will explore how changes in distress and coping influence pain and function at 6 months.
Conclusions:
- This large-scale, controlled trial will provide crucial evidence on the efficacy of a brief pre-surgical behavioral intervention for preventing persistent post-surgical pain and dysfunction.
- Findings may inform clinical practice for managing post-surgical recovery, particularly in veteran populations.
