杂志文章@ 1438- 8871% I JMIR出版物V 23% N 卡塔尔世界杯8强波胆分析9% P 29672% T单次“授权缓解”缩放交付的慢性疼痛群体干预的疗效:在COVID-19大流行期间进行的随机对照试验%A Ziadni,Maisa S %A冈萨雷斯-卡斯特罗，Lluvia %A Anderson,Steven %A Krishnamurthy,Parthasarathy %A Darnall,Beth D %+斯坦福大学医学院麻醉科，围手术期和疼痛医学，加州帕洛阿尔托Arastradero路1070号，94304，美国，1 6507365494，mziadni@stanford.edu %K单次会议%K授权缓解%K放大交付%K疼痛灾难化%K疼痛强度%K随机对照试验%K慢性疼痛%D 2021 %7 10.9.2021 %9原始论文%J J医学互联网Res %G英文%X背景:认知行为疗法-疼痛是一种基于证据的慢性疼痛治疗方法，可对患者造成重大负担，包括医疗保健费用、旅行、多次会议和偏远地区缺乏通路。目的:该研究旨在试点测试单次视频会议提供的授权缓解(ER)干预与慢性疼痛患者等待列表控制(WLC)条件的疗效。我们假设，在治疗后1-3个月，ER在减轻疼痛的严重程度、疼痛强度和其他疼痛相关结果方面优于WLC。方法:我们进行了一项随机对照试验，涉及基于网络的18-80岁自我报告慢性疼痛的成年人(N=104)样本。参与者被随机(1:1)分为2个非盲研究组:ER(50/104, 48.1%)和WLC(54/104, 51.9%)。分配到急诊室的参与者完成了zoom交付课程，所有参与者在治疗后2周、1、2和3个月完成了随访调查。所有的研究程序都是远程和电子执行的。主要结局为治疗后1个月的疼痛灾难化，次要结局为疼痛强度、疼痛烦扰性和睡眠中断。 We also report a more rigorous test of the durability of treatment effects at 3 months posttreatment. Data were collected from September 2020 to February 2021 and analyzed using intention-to-treat analysis. The analytic data set included participants (18/101, 17.8% clinic patients; 83/101, 82.1% community) who completed at least one study survey: ER (50/101, 49.5%) and WLC (51/104, 49%). Results: Participants (N=101) were 69.3% (70/101) female, with a mean age of 49.76 years (SD 13.90; range 24-78); 32.7% (33/101) had an undergraduate degree and self-reported chronic pain for 3 months. Participants reported high engagement (47/50, 94%), high satisfaction with ER (mean 8.26, SD 1.57; range 0-10), and high satisfaction with the Zoom platform (46/50, 92%). For the between-groups factor, ER was superior to WLC for all primary and secondary outcomes at 3 months posttreatment (highest P<.001), and between-groups Cohen d effect sizes ranged from 0.45 to 0.79, indicating that the superiority was of moderate to substantial clinical importance. At 3 months, clinically meaningful pain catastrophizing scale (PCS) reductions were found for ER but not for WLC (ER: PCS −8.72, 42.25% reduction; WLC: PCS −2.25, 11.13% reduction). ER resulted in significant improvements in pain intensity, sleep disturbance, and clinical improvements in pain bothersomeness. Conclusions: Zoom-delivered ER had high participant satisfaction and very high engagement. Among adults with chronic pain, this single-session, Zoom-delivered, skills-based pain class resulted in clinically significant improvement across a range of pain-related outcomes that was sustained at 3 months. Web-based delivery of ER could allow greater accessibility of home-based pain treatment and could address the inconveniences and barriers faced by patients when attempting to receive in-person care. Trial Registration: ClinicalTrials.gov NCT04546685; https://clinicaltrials.gov/ct2/show/NCT04546685 %M 34505832 %R 10.2196/29672 %U //www.mybigtv.com/2021/9/e29672 %U https://doi.org/10.2196/29672 %U http://www.ncbi.nlm.nih.gov/pubmed/34505832