{"title":"对全髋关节或膝关节置换术后亚急性疼痛的在线简短正念干预：随机对照试验","authors":"","doi":"10.1007/s12671-024-02329-2","DOIUrl":null,"url":null,"abstract":"<h3>Abstract</h3> <span> <h3>Objectives</h3> <p>Recent brief mindfulness-based interventions (MBI) provided before surgery have shown promising results in improving clinical outcomes in patients undergoing total joint arthroplasty (TJA). However, they have not been delivered in the subacute phase after surgery to target patients at risk for chronic postsurgical pain (CPSP). The use of technologies allowing remote and online delivery can help increase the accessibility of these interventions.</p> </span> <span> <h3>Method</h3> <p>We conducted a single site, two-arm pilot randomized controlled trial to evaluate the feasibility, acceptability, and preliminary effects of online Mini More (i.e., a condensed, 4-week mindfulness-based program) promoting pain self-management during the subacute postoperative phase. We randomized 36 patients into two groups (Mini MORE, <em>n =</em> 18 and Pain Coping Education, <em>n =</em> 18). Postoperative outcomes were: pain intensity, pain interference, analgesic medication use, pain catastrophizing, pain acceptance and mindfulness.</p> </span> <span> <h3>Results</h3> <p>Results indicated that Mini MORE was highly feasible and well received. Further, results indicated that pain intensity (<em>d =</em> 1.47, <em>p <</em> 0.001) as well as pain interference levels (<em>d =</em> 1.04, <em>p =</em> 0.005) and medication use (Cliff’s Delta=-0.56, <em>p</em> = 0.02) were significantly different between groups after treatment. Statistically significant group by time interactions were found for both pain intensity (<em>p</em> < 0.001) and pain interference (<em>p =</em> 0.003), and a trend toward a decrease in pain medication use (<em>p =</em> 0.05) was observed in favor of the Mini MORE group. No statistically significant differences were found between groups for pain acceptance (<em>d =</em> -0.58), pain catastrophizing (<em>d =</em> 0.01) and mindfulness (<em>d =</em> -0.23).</p> </span> <span> <h3>Conclusions</h3> <p>Our results suggest Mini MORE is a feasible and acceptable brief, online MBI potentially capable of decreasing pain intensity and pain interference in the subacute period after TJA, thus Mini MORE may be a promising tool for preventing CPSP.</p> </span> <span> <h3>Preregistration</h3> <p>NCT04848428</p> </span>","PeriodicalId":18523,"journal":{"name":"Mindfulness","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Online Brief Mindfulness-Based Intervention for Subacute Pain After Total Hip or Knee Replacement: A Pilot Randomized Controlled Trial\",\"authors\":\"\",\"doi\":\"10.1007/s12671-024-02329-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3>Abstract</h3> <span> <h3>Objectives</h3> <p>Recent brief mindfulness-based interventions (MBI) provided before surgery have shown promising results in improving clinical outcomes in patients undergoing total joint arthroplasty (TJA). However, they have not been delivered in the subacute phase after surgery to target patients at risk for chronic postsurgical pain (CPSP). The use of technologies allowing remote and online delivery can help increase the accessibility of these interventions.</p> </span> <span> <h3>Method</h3> <p>We conducted a single site, two-arm pilot randomized controlled trial to evaluate the feasibility, acceptability, and preliminary effects of online Mini More (i.e., a condensed, 4-week mindfulness-based program) promoting pain self-management during the subacute postoperative phase. We randomized 36 patients into two groups (Mini MORE, <em>n =</em> 18 and Pain Coping Education, <em>n =</em> 18). Postoperative outcomes were: pain intensity, pain interference, analgesic medication use, pain catastrophizing, pain acceptance and mindfulness.</p> </span> <span> <h3>Results</h3> <p>Results indicated that Mini MORE was highly feasible and well received. Further, results indicated that pain intensity (<em>d =</em> 1.47, <em>p <</em> 0.001) as well as pain interference levels (<em>d =</em> 1.04, <em>p =</em> 0.005) and medication use (Cliff’s Delta=-0.56, <em>p</em> = 0.02) were significantly different between groups after treatment. Statistically significant group by time interactions were found for both pain intensity (<em>p</em> < 0.001) and pain interference (<em>p =</em> 0.003), and a trend toward a decrease in pain medication use (<em>p =</em> 0.05) was observed in favor of the Mini MORE group. No statistically significant differences were found between groups for pain acceptance (<em>d =</em> -0.58), pain catastrophizing (<em>d =</em> 0.01) and mindfulness (<em>d =</em> -0.23).</p> </span> <span> <h3>Conclusions</h3> <p>Our results suggest Mini MORE is a feasible and acceptable brief, online MBI potentially capable of decreasing pain intensity and pain interference in the subacute period after TJA, thus Mini MORE may be a promising tool for preventing CPSP.</p> </span> <span> <h3>Preregistration</h3> <p>NCT04848428</p> </span>\",\"PeriodicalId\":18523,\"journal\":{\"name\":\"Mindfulness\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2024-03-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Mindfulness\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12671-024-02329-2\",\"RegionNum\":2,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Mindfulness","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12671-024-02329-2","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
摘要 目的 最近在手术前提供的简短正念干预（MBI）在改善全关节成形术（TJA）患者的临床疗效方面取得了可喜的成果。然而，这些干预尚未在术后亚急性阶段针对有慢性术后疼痛（CPSP）风险的患者进行。使用远程和在线技术有助于提高这些干预措施的可及性。 方法 我们在单个地点开展了一项双臂随机对照试验，以评估在线 Mini More（即一个为期 4 周、基于正念的浓缩项目）的可行性、可接受性和初步效果，从而促进术后亚急性阶段的疼痛自我管理。我们将 36 名患者随机分为两组（Mini MORE，18 人；疼痛应对教育，18 人）。术后结果包括：疼痛强度、疼痛干扰、镇痛药物使用、疼痛灾难化、疼痛接受度和正念。 结果 结果表明，Mini MORE 非常可行，而且深受欢迎。此外，结果表明，疼痛强度（d = 1.47，p < 0.001）、疼痛干扰水平（d = 1.04，p = 0.005）和药物使用（Cliff's Delta=-0.56，p = 0.02）在治疗后组间存在显著差异。在疼痛强度（p <0.001）和疼痛干扰（p = 0.003）方面，发现了具有统计学意义的组间时间交互作用，并观察到 Mini MORE 组的疼痛药物使用量呈下降趋势（p = 0.05）。在疼痛接受度（d = -0.58）、疼痛灾难化（d = 0.01）和正念（d = -0.23）方面，组间差异无统计学意义。 结论 我们的研究结果表明，Mini MORE 是一种可行且可接受的简短在线 MBI，有可能降低 TJA 术后亚急性期的疼痛强度和疼痛干扰，因此 Mini MORE 有可能成为预防 CPSP 的有效工具。 预注册 NCT04848428
Online Brief Mindfulness-Based Intervention for Subacute Pain After Total Hip or Knee Replacement: A Pilot Randomized Controlled Trial
Abstract
Objectives
Recent brief mindfulness-based interventions (MBI) provided before surgery have shown promising results in improving clinical outcomes in patients undergoing total joint arthroplasty (TJA). However, they have not been delivered in the subacute phase after surgery to target patients at risk for chronic postsurgical pain (CPSP). The use of technologies allowing remote and online delivery can help increase the accessibility of these interventions.
Method
We conducted a single site, two-arm pilot randomized controlled trial to evaluate the feasibility, acceptability, and preliminary effects of online Mini More (i.e., a condensed, 4-week mindfulness-based program) promoting pain self-management during the subacute postoperative phase. We randomized 36 patients into two groups (Mini MORE, n = 18 and Pain Coping Education, n = 18). Postoperative outcomes were: pain intensity, pain interference, analgesic medication use, pain catastrophizing, pain acceptance and mindfulness.
Results
Results indicated that Mini MORE was highly feasible and well received. Further, results indicated that pain intensity (d = 1.47, p < 0.001) as well as pain interference levels (d = 1.04, p = 0.005) and medication use (Cliff’s Delta=-0.56, p = 0.02) were significantly different between groups after treatment. Statistically significant group by time interactions were found for both pain intensity (p < 0.001) and pain interference (p = 0.003), and a trend toward a decrease in pain medication use (p = 0.05) was observed in favor of the Mini MORE group. No statistically significant differences were found between groups for pain acceptance (d = -0.58), pain catastrophizing (d = 0.01) and mindfulness (d = -0.23).
Conclusions
Our results suggest Mini MORE is a feasible and acceptable brief, online MBI potentially capable of decreasing pain intensity and pain interference in the subacute period after TJA, thus Mini MORE may be a promising tool for preventing CPSP.
期刊介绍：
Mindfulness seeks to advance research, clinical practice, and theory on mindfulness. It is interested in manuscripts from diverse viewpoints, including psychology, psychiatry, medicine, neurobiology, psychoneuroendocrinology, cognitive, behavioral, cultural, philosophy, spirituality, and wisdom traditions. Mindfulness encourages research submissions on the reliability and validity of assessment of mindfulness; clinical uses of mindfulness in psychological distress, psychiatric disorders, and medical conditions; alleviation of personal and societal suffering; the nature and foundations of mindfulness; mechanisms of action; and the use of mindfulness across cultures. The Journal also seeks to promote the use of mindfulness by publishing scholarly papers on the training of clinicians, institutional staff, teachers, parents, and industry personnel in mindful provision of services. Examples of topics include: Mindfulness-based psycho-educational interventions for children with learning, emotional, and behavioral disorders Treating depression and clinical symptoms in patients with chronic heart failure Yoga and mindfulness Cognitive-behavioral mindfulness group therapy interventions Mindfulnessness and emotional regulation difficulties in children Loving-kindness meditation to increase social connectedness Training for parents and children with ADHD Recovery from substance abuse Changing parents’ mindfulness Child management skills Treating childhood anxiety and depression
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