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Evaluation of an interdisciplinary chronic pain program and predictors of readiness for change

机译:跨学科慢性疼痛项目的评估和变革准备情况的预测指标

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摘要

Background: One in five Canadians experience chronic pain, and interdisciplinary pain programs are well established as the gold standard of treatment. However, not all patients are ready to engage in interdisciplinary treatment for chronic pain.Aims: The aims of this study were to (1) first demonstrate changes in patient-related outcomes after attending a publicly funded 8-week interdisciplinary pain program and (2) evaluate pain-related predictors of readiness for change.Methods: The institution’s research ethics board approved this study. One hundred twenty-nine patients completed questionnaires on the first and last day of attending the program. Paired sample t-tests were utilized to evaluate the changes in patient-related outcomes after attending the program, and linear regressions were utilized to evaluate pain-related predictors of the stages of change.Results: Postprogram, there were significant decreases in pain-related interference, fear of pain/re-injury, pain catastrophizing, and symptoms of stress, depression, and anxiety and a significant increase in wellness-focused coping and self-efficacy. Postprogram, patients also demonstrated lower scores in precontemplation and contemplation and higher scores in action and maintenance stages of readiness for change. In predicting precontemplation, fear of pain/re-injury was the sole predictor, and self-efficacy was the sole predictor of the contemplation, action, and maintenance stages.Conclusion: These results demonstrate the short-term benefits of an 8-week interdisciplinary pain program. It is suggested that preprogram interventions targeting kinesophobia for individuals who are precontemplative and self-efficacy for others may be important to facilitate patient engagement.
机译:背景: 五分之一的加拿大人经历慢性疼痛,跨学科疼痛计划已被公认为治疗的黄金标准。然而,并非所有患者都准备好接受慢性疼痛的跨学科治疗。目的:本研究的目的是 (1) 首先证明参加公共资助的为期 8 周的跨学科疼痛计划后患者相关结果的变化,以及 (2) 评估与疼痛相关的变化准备预测因子。方法:该机构的研究伦理委员会批准了这项研究。129 名患者在参加该计划的第一天和最后一天完成了问卷调查。使用配对样本 t 检验来评估参加该计划后患者相关结果的变化,并使用线性回归来评估变化阶段的疼痛相关预测因子。结果: 程序后,与疼痛相关的干扰、对疼痛/再损伤的恐惧、疼痛灾难化以及压力、抑郁和焦虑症状显着减少,以健康为中心的应对和自我效能感显着增加。项目后,患者在预思考和沉思方面的得分也较低,在行动和保持改变准备阶段的得分较高。在预测预想时,对疼痛/再受伤的恐惧是唯一的预测因素,而自我效能感是沉思、行动和维护阶段的唯一预测因素。结论:这些结果证明了为期 8 周的跨学科疼痛计划的短期益处。建议针对预思考和他人自我效能的个体的运动恐惧症进行项目前干预对于促进患者参与可能很重要。

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