Müller Rachel, Gertz Kevin J, Molton Ivan R, Terrill Alexandra L, Bombardier Charles H, Ehde Dawn M, Jensen Mark P
*Department of Rehabilitation Medicine, University of Washington, Seattle, WA †Swiss Paraplegic Research, Nottwil, Switzerland.
Clin J Pain. 2016 Jan;32(1):32-44. doi: 10.1097/AJP.0000000000000225.
To determine the feasibility, acceptability, and efficacy of a computer-based positive psychology intervention in individuals with a physical disability and chronic pain.
Individuals with spinal cord injury, multiple sclerosis, neuromuscular disease, or postpolio syndrome and chronic pain were randomly assigned to a positive psychology or a control condition. Participants in the intervention group were instructed to practice 4 personalized positive psychology exercises. Participants in the control group were instructed to write about life details for 8 weeks. Participants completed online well-being and pain-related questionnaires at baseline, posttreatment, and at the 2.5-month follow-up, and rated treatment satisfaction at posttreatment.
Ninety-six participants were randomized and 68 (70%) completed follow-up assessments. Participants in the positive psychology intervention group reported significant pretreatment to posttreatment improvements in pain intensity, pain control, pain catastrophizing, pain interference, life satisfaction, positive affect, and depression. Improvements in life satisfaction, depression, pain intensity, pain interference, and pain control were maintained to the 2.5-month follow-up. Participants in the control group reported significant pretreatment to posttreatment improvements in life satisfaction, and pretreatment to follow-up improvements in pain intensity and pain control. Significant between-group differences, favoring the treatment group, emerged for pretreatment to posttreatment improvements in pain intensity and pain control. Participants were similarly satisfied with both treatments.
DISCUSSION/CONCLUSIONS: The results support the feasibility, acceptability, and potential efficacy of a computer-based positive psychology intervention for improving well-being and pain-related outcomes in individuals with physical disabilities and chronic pain, and indicate that a full trial of the intervention is warranted.
确定基于计算机的积极心理学干预对身体残疾和慢性疼痛患者的可行性、可接受性及疗效。
将脊髓损伤、多发性硬化症、神经肌肉疾病或小儿麻痹后遗症及慢性疼痛患者随机分为积极心理学组或对照组。干预组参与者被指导进行4项个性化的积极心理学练习。对照组参与者被指导在8周内记录生活细节。参与者在基线、治疗后及2.5个月随访时完成在线幸福感和疼痛相关问卷,并在治疗后对治疗满意度进行评分。
96名参与者被随机分组,68名(70%)完成了随访评估。积极心理学干预组参与者报告,从治疗前到治疗后,疼痛强度、疼痛控制、疼痛灾难化、疼痛干扰、生活满意度、积极情绪和抑郁均有显著改善。生活满意度、抑郁、疼痛强度、疼痛干扰和疼痛控制的改善持续到2.5个月随访时。对照组参与者报告,从治疗前到治疗后生活满意度有显著改善,从治疗前到随访时疼痛强度和疼痛控制有改善。在疼痛强度和疼痛控制从治疗前到治疗后的改善方面,出现了有利于治疗组的显著组间差异。参与者对两种治疗的满意度相似。
讨论/结论:结果支持基于计算机的积极心理学干预在改善身体残疾和慢性疼痛患者的幸福感和疼痛相关结局方面的可行性、可接受性及潜在疗效,并表明有必要对该干预进行全面试验。