interdisciplinary pain rehabilitation program

跨学科疼痛康复计划
  • 文章类型: Journal Article
    UNASSIGNED:由于复杂性,在跨学科疼痛治疗(IPT)的所有系统评价(SRs)中,处理多个结果的结果选择和方法具有相当大的多样性。这种多样性给医疗保健决策者带来了困难。需要关于如何在SRs中选择结果(有或没有荟萃分析)的更好建议,以明确证明IPT的有效性。
    UNASSIGNED:本概述系统地整理了已发布的SRs中IPT的报告结果和测量结果,并确定了方法学特征。此外,我们为制定结果选择和进行IPTSRs提供了一些建议。
    UNASSIGNED:三个电子数据库(PubMed,科克伦图书馆,和Epistemonikos)和正在进行的SR的PROSPERO注册表得到了补充,手工搜索于2021年9月30日结束。
    UNASSIGNED:我们纳入了来自356项主要随机对照试验(RCT)的49007人的18个SR数据;8个随后是荟萃分析和10个使用的叙述性数据综合。对于所有的SR,疼痛是最常见的报告结局(72%),其次是残疾/功能状态(61%)和工作状态(61%)。其中一半的SR(50%)也报告了心理健康和生活质量。根据VAPAIN的核心结果域,IMMPACT,和PROMIS很少被满足。根据AMSTAR2,方法学质量从极低到中等不等。AMSTAR2评分与PROMIS中结果域的数量呈负相关,VAPAIN与IMMPACT和PROMIS呈正相关,表明报告结果之间的相互关系。
    UNASSIGNED:该系统概述显示,在评估IPT干预措施对慢性疼痛状况的SRs中,报告的结果和应用的结果领域存在广泛差异。报告的结果之间的相互关系应在未来的研究中适当处理。还讨论了一些方法。
    UNASSIGNED: There is considerable diversity of outcome selections and methodologies for handling the multiple outcomes across all systematic reviews (SRs) of Interdisciplinary Pain Treatment (IPT) due to the complexity. This diversity presents difficulties for healthcare decision makers. Better recommendations about how to select outcomes in SRs (with or without meta-analysis) are needed to explicitly demonstrate the effectiveness of IPT.
    UNASSIGNED: This overview systematically collates the reported outcomes and measurements of IPT across published SRs and identifies the methodological characteristics. Additionally, we provide some suggestions on framing the selection of outcomes and on conducting SRs of IPT.
    UNASSIGNED: Three electronic databases (PubMed, Cochrane Library, and Epistemonikos) and the PROSPERO registry for ongoing SR were supplemented with hand-searching ending on 30 September 2021.
    UNASSIGNED: We included 18 SRs with data on 49007 people from 356 primary randomised controlled trials (RCTs); eight were followed by meta-analysis and ten used narrative syntheses of data. For all the SRs, pain was the most common reported outcome (72%), followed by disability/functional status (61%) and working status (61%). Psychological well-being and quality of life were also reported in half of the included SR (50%). The core outcome domains according to VAPAIN, IMMPACT, and PROMIS were seldom met. The methodological quality varied from critically low to moderate according to AMSTAR2. The AMSTAR2 rating was negatively correlated to the number of outcome domains in PROMIS, and VAPAIN was positively correlated with IMMPACT and PROMIS, indicating the intercorrelations between the reported outcomes.
    UNASSIGNED: This systematic overview showed wide-ranging disparity in reported outcomes and applied outcome domains in SRs evaluating IPT interventions for chronic pain conditions. The intercorrelations between the reported outcomes should be appropriately handled in future research. Some approaches are discussed as well.
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  • 文章类型: Journal Article
    强化跨学科疼痛治疗(IIPT)涉及多个利益相关者。将程序组件映射到其预期结果(即,其理论)可能很困难,需要利益相关者的参与。缺乏证据,然而,如何最好地吸引他们。逻辑分析,基于理论的评估,使用科学证据和经验知识测试程序理论的连贯性可能会带来一些希望。它在儿科疼痛干预中很少使用,几乎没有方法细节。本文介绍了一种协作逻辑分析方法,该方法用于测试为与疼痛相关的残疾青年设计的IIPT的理论合理性。使用3步直接逻辑分析过程。由13人组成的专家小组,由临床医生组成,教师,经理,患有疼痛相关残疾的年轻人,和他们的父母,参与每一步。首先,通过文档分析构建了逻辑模型,专家小组调查,和焦点小组讨论。然后,范围审查,专注于儿科自我管理,建立自我效能感,促进参与,帮助创建了一个概念框架。随后,专家小组根据概念框架对逻辑模型进行了检查,并提出了建议。总的来说,协作逻辑分析过程有助于提高临床医生对程序因果机制的假设的认识,确定了年轻人及其父母最重视的计划组成部分,认可由科学和经验知识支持的计划功能,检测到的间隙,并强调了新兴趋势。除了提供以消费者为中心的计划评估选项外,协作逻辑分析方法有望成为吸引利益相关者并将儿科疼痛康复评估研究知识转化为关键利益相关者的策略。
    Intensive interdisciplinary pain treatment (IIPT) involves multiple stakeholders. Mapping the program components to its anticipated outcomes (ie, its theory) can be difficult and requires stakeholder engagement. Evidence is lacking, however, on how best to engage them. Logic analysis, a theory-based evaluation, that tests the coherence of a program theory using scientific evidence and experiential knowledge may hold some promise. Its use is rare in pediatric pain interventions, and few methodological details are available. This article provides a description of a collaborative logic analysis methodology used to test the theoretical plausibility of an IIPT designed for youth with pain-related disability. A 3-step direct logic analysis process was used. A 13-member expert panel, composed of clinicians, teachers, managers, youth with pain-related disability, and their parents, were engaged in each step. First, a logic model was constructed through document analysis, expert panel surveys, and focus-group discussions. Then, a scoping review, focused on pediatric self-management, building self-efficacy, and fostering participation, helped create a conceptual framework. An examination of the logic model against the conceptual framework by the expert panel followed, and recommendations were formulated. Overall, the collaborative logic analysis process helped raiseawareness of clinicians\' assumptions about the program causal mechanisms, identified program components most valued by youth and their parents, recognized the program features supported by scientific and experiential knowledge, detected gaps, and highlighted emerging trends. In addition to providing a consumer-focused program evaluation option, collaborative logic analysis methodology holds promise as a strategy to engage stakeholders and to translate pediatric pain rehabilitation evaluation research knowledge to key stakeholders.
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