认知行为训练对慢性腰痛患者疼痛自我效能的影响

Effect of cognitive behavior training on pain self-efficacy in patients with chronic back pain

目的探讨认知行为训练对慢性腰痛(chronic back pain,CBP)患者疼痛自我效能的影响。方法选择2018年2月~2019年12月在本院就诊的94例CBP患者作为研究对象,采用随机数字表法分为对照组和观察组各47例。对照组给予推拿按摩治疗,观察组在对照组的基础上给予认知行为训练。观察两组患者干预前后疼痛强度(VAS评分)、疼痛自我效能(PSEQ评分)、疼痛应用策略的使用频率及痛阈值。结果两组患者干预后VAS评分均较干预前显著降低(P<0.05),PSEQ均较干预前显著升高(P<0.05),积极策略使用频率均显著高于干预前(P<0.05),消极策略应用频率均显著低于干预前(P<0.05);且观察组干预后的上述指标改善效果均显著优于同期对照组,差异有统计学意义(P<0.05)。观察组患者干预后的痛阈显著高于干预前,且高于同期对照组,差异均有统计学意义(P<0.05)。结论认知行为训练可提高CBP患者的疼痛自我效能,降低患者消极疼痛策略使用频率,增加其积极疼痛应对策略使用频率,提高痛阈,从而降低疼痛水平,改善疼痛控制效果。

Objective To explore the effect of cognitive behavior training on pain self-efficacy in patients with chronic back pain(CBP).Methods From February 2018 to December 2019,94 CBP patients who were treated in our hospital were selected in this study,and the patients were divided into control group and observation group by random number table method.The control group was treated with massage,and the observation group was given cognitive behavior training on the basis of the control group.The pain intensity(VAS),pain self-efficacy(PSEQ),frequency of pain application strategy and pain threshold were observed before and after intervention.Results After intervention,the VAS scores of the two groups were significantly lower than before intervention(P<0.05),the PSEQ was significantly higher than before intervention(P<0.05),the frequency of positive strategies was significantly higher than before intervention(P<0.05),and the frequency of negative strategies was significantly lower than before intervention(P<0.05).The improvement effect of the above indicators in the observation group after intervention was significantly better than that in the control group at the same period,and the difference was statistically significant(P<0.05).After intervention,the pain threshold of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Cognitive behavior training can improve the pain self-efficacy of CBP patients,reduce the frequency of using passive pain strategies,increase the frequency of using active pain coping strategies,and improve the pain threshold,so as to reduce the level of pain and improve the effect of pain control.