德尔菲专家咨询法的疼痛自我管理方案对中轴型脊柱关节炎患者的影响

Effect of a pain self-management program based on Delphi expert consultation for patients with axial spinal arthritis

目的探究基于德尔菲专家咨询法的疼痛自我管理方案应用于中轴型脊柱关节炎(axSpA)患者的效果。方法选取河南科技大学第一附属医院风湿免疫科2021年1月至2022年10月113例axSpA患者进行前瞻性研究,以抽签法分组,在研究过程中失访3例,最终对照组54例,观察组56例。对照组男45例、女9例,年龄27~37(30.54±2.77)岁,给予常规治疗护理;观察组男48例、女8例,年龄27~36(30.22±3.16)岁,给予基于德尔菲专家咨询法的疼痛自我管理方案。对比两组疼痛控制效果、疼痛自我管理行为及脊柱功能。统计学方法使用t检验与秩和检验。结果干预后,观察组简明疼痛量表(BPI)分低于对照组[(21.06±4.87)分比(35.94±5.21)分],差异有统计学意义(t=15.48,P<0.05)。干预后,观察组疼痛阶段变化问卷(PSOCQ)中的行动期和维持期均高于对照组[28.57%(16/56)比12.96%(7/54)、50.00%(28/56)比29.63%(16/54)],差异有统计学意义(Z=3.33,P<0.05)。结论采用常规治疗护理与基于德尔菲专家咨询法的疼痛自我管理方案对axSpA患者干预后,患者疼痛自我效能、脊柱功能改善效果相当,但疼痛自我管理方案的降低疼痛程度、改善疼痛自我管理行为效果更优。

Objective To explore the effect of pain self-management program based on the Delphi expert consultation for patients with axial spinal arthritis(axSpA).Methods One hundred and thirteen patients with axSpA treated at Department of Rheumatology and Immunology,First Hospital,Henan University of Science and Technology from January 2021 to October 2022 were selected for the prospective study,and were grouped by the lottery method.During the study,3 cases were lost to the follow up;at last,there were 54 cases in the control group and 56 cases in the observation group.In the control group,there were 45 males and 9 females;they were 27-37(30.54±2.77)years old;they were given routine treatment and nursing.In the observation group,there were 48 males and 8 females;they were 27-36(30.22±3.16)years old;they were given pain self-management based on the Delphi expert consultation.The pain control effects,pain self-management behaviors,and spinal function were compared between the two groups.t test and rank sum test were used.Results After the intervention,the score of Brief Pain Inventory(BPI)in the observation group was lower than that in the control group[(21.06±4.87)vs.(35.94±5.21)],with a statistical difference(t=15.48,P<0.05).After the intervention,the numbers of mobility period and maintenance period in Pain Stages of Change Questionnaire(PSOCQ)in the observation group were higher than those in the control group[28.57%(16/56)vs.12.96%(7/54)and 50.00%(28/56)vs.29.63%(16/54)],with a statistical difference(Z=3.33,P<0.05).Conclusions Conventional treatment and nursing and the pain self-management program based on Delphi expert consultation for axSpA patients both can improve their pain self-efficacy and spinal function,but the pain self-management program is better in reducing their pain and improving their pain self-management behaviors.