An Interdisciplinary Multimodal Integrative Healthcare Program for Chronic Spinal Pain and Comorbid Mental Disorders.

IF 2.9 3区 医学 Q2 PSYCHIATRY
Psychosomatic Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-01 DOI:10.1097/PSY.0000000000001316
Jaap Wijnen, Marciano Wilhelmina Henricus Geijselaers, Marc Lucas Pont, Geert Van't Hullenaar, Jessica Van Oosterwijck, Jeroen de Jong
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引用次数: 0

Abstract

Objective: Previous studies evaluating interdisciplinary multimodal interventions for chronic spinal pain often excluded patients with comorbid mental disorders. This study aims to assess the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program for individuals experiencing co-occurring chronic spinal pain and mental disorders.

Methods: Participants were 944 patients with chronic spinal pain and comorbid mental disorders. Primary outcomes were health-related quality of life, assessed using the Research and Development-36 (RAND-36), and pain-related disability, assessed using the Quebec Back Pain Disability Scale (QBPDS). Secondary outcomes included pain intensity, pain catastrophizing, kinesiophobia, fatigue, lumbar mobility, and isometric strength. Data were collected during the healthcare program at four time points: pretreatment (T0), midway through 20-week treatment (T1), end of 20-week treatment (T2), and at completion of 12-month relapse prevention program (T3). Multilevel regression analyses were conducted to examine the effects of the healthcare program on primary outcomes over time.

Results: The 20-week treatment period yielded significant improvements in both mental ( B = 0.44, t (943) = 19.42, p < .001) and physical component summary scores ( B = 0.45, t (943) = 18.24, p < .001) of the RAND-36, as well as in QBPDS total score ( B = -0.77, t (943) = -26.16 p < .001). Pretreatment scores indicated the presence of problematic fatigue, kinesiophobia, and clinical levels of pain catastrophizing, all of which resolved by the end of the 12-month relapse prevention program.

Conclusions: An interdisciplinary multimodal integrative healthcare program seems effective for patients with chronic spinal pain and comorbid mental disorders.

针对慢性脊柱疼痛和合并精神障碍的跨学科多模式综合保健计划。
目的:以往评估慢性脊柱疼痛跨学科多模式干预措施的研究往往将合并精神障碍的患者排除在外。本研究旨在评估门诊二级护理跨学科多模式综合医疗保健项目对合并慢性脊柱疼痛和精神障碍患者的疗效:参与者为 944 名患有慢性脊柱疼痛和合并精神障碍的患者。主要结果是健康相关生活质量(使用研究与发展-36(RAND-36)进行评估)和疼痛相关残疾(使用魁北克背痛残疾量表(QBPDS)进行评估)。次要结果包括疼痛强度、疼痛灾难化、运动恐惧症、疲劳、腰部活动度和等长肌力。在医疗保健计划期间收集了四个时间点的数据:治疗前(T0)、20 周治疗中期(T1)、20 周治疗结束(T2)和为期 12 个月的复发预防计划完成时(T3)。研究人员进行了多层次回归分析,以考察医疗保健计划对不同时期主要结果的影响:为期 20 周的治疗期使 RAND-36 心理(B = 0.44,t(943) = 19.42,p < 0.001)和身体部分总分(B = 0.45,t(943) = 18.24,p < 0.001)以及 QBPDS 总分(B = -0.77,t(943) = -26.16,p < 0.001)均有显著改善。治疗前的评分表明,患者存在疲劳问题、运动恐惧症和疼痛灾难化的临床水平,所有这些问题在为期12个月的复发预防计划结束时都得到了解决:结论:跨学科多模式综合医疗保健计划似乎对慢性脊柱疼痛和合并精神障碍的患者很有效。
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来源期刊
Psychosomatic Medicine
Psychosomatic Medicine 医学-精神病学
CiteScore
5.10
自引率
0.00%
发文量
258
审稿时长
4-8 weeks
期刊介绍: Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society. The journal publishes experimental, clinical, and epidemiological studies on the role of psychological and social factors in the biological and behavioral processes relevant to health and disease. Psychosomatic Medicine is an interdisciplinary peer-reviewed journal devoted to high-quality science on biobehavioral mechanisms, brain-behavior interactions relevant to physical and mental disorders, as well as interventions in clinical and public health settings. Psychosomatic Medicine was founded in 1939 and publishes interdisciplinary research articles relevant to medicine, psychiatry, psychology, and other health-related disciplines. The print journal is published nine times a year; most articles are published online ahead of print. Supplementary issues may contain reports of conferences at which original research was presented in areas relevant to the psychosomatic and behavioral medicine.
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