疼痛灾难化和疼痛焦虑介导身体功能的变化在心身干预的创伤性骨科伤害的成年人心理干预
Katherine E Gnall1, Kate N Jochimsen2, Julie R Brewer2
1Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut.
Pain
|December 11, 2024
概括
像最佳恢复工具包 (TOR) 这样的心身干预可以减少骨科创伤后的疼痛灾难化和焦虑. 这些减少显著改善了身体功能,强调了心理社会支持的重要性.
科学领域:
- 心理学 心理学 心理学
- 整形外科 整形外科 整形外科
- 康复医学 康复医学 康复医学
背景情况:
- 创伤性骨科伤害往往导致持续的疼痛,残疾和情绪困扰.
- 疼痛灾难化和疼痛焦虑是导致不良结果的关键风险因素.
- 目前的治疗主要集中在生物医学方法上,经常忽视心理因素.
研究的目的:
- 调查减少疼痛灾难化和疼痛焦虑在改善身体功能的调解作用.
- 在对可行性RCT的二次分析中,分析最佳恢复工具包 (TOR) 心身计划的有效性.
- 检查心理社会干预对创伤性骨科损伤后身体功能的影响.
主要方法:
- 一个多站点可行性随机对照试验 (RCT) 的二次分析,将TOR与最小增强常规护理 (MEUC) 进行比较.
- 包括195名近期骨科创伤的参与者,在基线,干预后和3个月后期进行评估.
- 利用多层结构方程建模 (MSEM) 进行多重调解分析.
主要成果:
- 减轻灾难性疼痛显著介导身体功能改善 (b = -5.22).
- 疼痛和焦虑的减少也显著介导了身体功能的改善 (b = -8.45).
- 这两种机制在启动后的95%置信区间内都显示出了显著的调解效应.
结论:
- 研究结果阐明了TOR通过针对疼痛灾难化和焦虑来改善身体功能的机制性途径.
- 早期的心理社会干预,如TOR,对于减轻骨科损伤后持续残疾至关重要.
- 针对疼痛灾难化和焦虑等心理因素对于骨科创伤患者全面康复至关重要.
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