在初级保健中治疗慢性疼痛和负面情绪的老年人的问题适应疗法 (PATH-疼痛):一项随机临床试验
Dimitris N Kiosses1, Lisa D Ravdin2, Samprit Banerjee3
1Weill-Cornell Institute of Geriatric Psychiatry (DNK, JP), Weill Cornell Medicine, White Plains, NY, USA.
概括
疼痛问题适应疗法 (PATH-Pain) 显著减少了10周以上慢性疼痛的老年人与疼痛相关的残疾和抑郁症. 然而,这些好处在随访期间没有持续.
科学领域:
- 老年医学 老年医学
- 心理社会干预 心理社会干预
- 疼痛管理 疼痛管理
背景情况:
- 慢性疼痛在老年人中很普遍,通常伴随着负面情绪和功能限制.
- 需要有效的干预措施来管理与疼痛相关的残疾和抑郁症,特别是在初级保健机构.
研究的目的:
- 评估与常规护理 (UC) 相比,疼痛问题适应疗法 (PATH-Pain) 在老年人中减少与疼痛相关的残疾,疼痛强度和抑郁症的有效性.
- 评估PATH-Pain对情绪调节和治疗满意度的影响.
主要方法:
- 一项随机对照试验 (RCT) 在老年人初级保健中心进行.
- 100名患有慢性疼痛和负面情绪的老年人 (平均年龄75.5,80%为女性) 被随机分为PATH-Pain (N=49) 或UC (N=51).
- 该研究评估了急性阶段 (0-10周) 和随访阶段 (11-24周) 的结果.
主要成果:
- 在急性阶段,与UC相比,PATH-Pain显著降低了与疼痛相关的残疾 (P=0.02) 和抑郁症严重程度 (P=0.03).
- PATH-Pain还改善了表达性抑制,这是情绪调节的一个组成部分 (P=0.010).
- 在急性阶段或随访阶段,在各组之间没有观察到疼痛强度的显著差异,也没有观察到任何结果.
结论:
- 疼痛问题适应疗法 (PATH-Pain) 在治疗慢性疼痛和负面情绪的老年人中改善与疼痛相关的残疾和抑郁的短期有效性.
- 这些发现强调了初级保健中有针对性的心理社会干预在老年人群中管理复杂疼痛状况的潜力.
- 进一步的研究是有必要的,以探索长期影响和优化干预策略,以获得持续的好处.
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