多学科协作下认知行为干预在慢性腰痛恐动症患者中的应用

Multidisciplinary cognition behavior intervention alleviates kinesiophobia in patients with chronic low back pain

目的:研究多学科协作下认知行为干预方案对慢性腰痛患者恐动症的影响。方法:采用便利抽样的方法,于2019年6—10月选取南通市某三级甲等医院脊柱外科门诊就诊的150例慢性腰痛恐动症患者作为研究对象,按照就诊先后顺序分为观察组和对照组,各75例。对照组由医护人员提供常规诊疗及健康教育;观察组采用由骨科护士、脊柱外科医生、康复师、心理咨询师等多学科团队制订的认知行为干预,分别于干预后1周、3周、3个月和6个月评价两组患者的疼痛、恐动情况及功能障碍情况,并于干预后6个月比较两组患者的遵医行为及再就诊率。结果:①观察组恐动评分在干预后各时间点均低于对照组(P<0.05);②观察组疼痛评分、功能障碍评分在干预后3周、3个月均低于对照组(P<0.05);③观察组6个月后的遵医行为优于对照组,再就诊率低于对照组(P<0.05)。结论:多学科协作下的认知行为干预可降低慢性腰痛患者恐动程度,促进腰椎功能的恢复,提高患者遵医行为。

Objective:To explore the influences of a multidisciplinary cognition intervention program on kinesiophobia in patients with chronic low back pain.Methods:A total of 150 chronic low back pain patients with kinesiophobia treated in the Spine Surgery Clinic of Nantong First People's Hospital from March 2018 to October 2018 were recruited,and randomly assigned into the observation group(n=75)and the control group(n=75).Conventional treatment and health education were applied in the control group while the multidisciplinary cognition intervention program involving nurses,spine surgeons,therapists and psychiatrists was applied in the observation group.Indicators including pain,kinesiophobia and dysfunction were assessed 1 week,3 weeks,3 months and 6 months after treatment.Compliance behaviors and revisit rate were compared 6 months after treatment between groups.Results:(1)The scores of pain and dysfunction(ODI score)at 3 weeks and 3 months in the observation group were significantly lower than those of the control group(P<0.05)and the scores of Tampa Scale For Kinesiophobia(TSK)were significantly lower in the observation group at all the indicated time points than the control group(P<0.05).(2)A higher rate of compliance behaviors and lower revisit rate were detected in the observation group at 6 months compared with those of the control group(P<0.05).Conclusion:The multidisciplinary cognition intervention program is beneficial to alleviate kinesiophobia,promote recovery of lumbar function,enhance compliance behaviors and reduce revisit rate in patients with chronic low back pain.