Mindfulness-Based Training for Women Veterans With Chronic Pain: A Retrospective Study

被引:10
作者
Okvat, Heather A. [1 ,4 ]
Davis, Mary C. [2 ]
Mistretta, Erin G. [2 ]
Mardian, Aram S. [1 ,3 ]
机构
[1] Phoenix VA Hlth Care Syst, Chron Pain Wellness Ctr, Phoenix, AZ USA
[2] Arizona State Univ, Dept Psychol, Tempe, AZ 85287 USA
[3] Univ Arizona, Dept Family Commun & Preventat Med, Coll Med, Tucson, AZ 85721 USA
[4] Phoenix VA Hlth Care Syst, Dept Res, Phoenix, AZ USA
关键词
chronic pain; mindfulness; women; veterans; trauma; POSTTRAUMATIC-STRESS-DISORDER; COGNITIVE-BEHAVIORAL THERAPY; MILITARY SEXUAL TRAUMA; QUALITY-OF-LIFE; FEMALE VETERANS; SELF-EFFICACY; MUSCULOSKELETAL PAIN; HEALTH; DEPRESSION; INTERVENTIONS;
D O I
10.1037/ser0000599
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
The majority of women veterans experience chronic pain and many have comorbid posttraumatic stress disorder (PTSD). To enhance resilience in these veterans in terms of both physical functioning and psychosocial well-being, a mindfulness-based, trauma-informed, eight-session group pilot program was designed to target emotion regulation and social belonging. Women who engaged in treatment were asked to complete questionnaires assessing pain, functioning, and affective and social well-being before and after the program. The present retrospective research study evaluated (a) whether women who engaged in treatment showed pre-to-post treatment improvement in psychosocial and physical functioning and (b) whether women referred to the program who engaged versus did not engage in treatment differed in demographic and clinical data (i.e., pain diagnoses, mental health diagnoses, documented trauma history) obtained from medical record review. The sample consisted of 36 women who began the program and filled out a pregroup questionnaire (intent-to-treat sample; ITT) and 105 women who were referred but did not engage in treatment. The majority had a documented history of trauma, a mood disorder, and a PTSD diagnosis. ITT analyses indicated that veterans showed moderate-to-large pre-post improvements in pain severity, pain catastrophizing, physical functioning, depression, self-compassion, and positive affect. Veterans who engaged in treatment were similar to those who did not in demographics, number of pain diagnoses, and mental health diagnoses, but were more likely to have a documented history of trauma. Despite the limitations of this study, the findings are encouraging and point to the value of a future randomized controlled trial. Impact Statement Women veterans with chronic pain who participated in a trauma-informed, mindfulness-based training tailored to address their prevalent comorbid trauma, mood disturbance, and social isolation showed substantial improvements in physical and emotional health and credited the program with increasing their pain management options. Tailoring treatment to target the unique challenges faced by women veterans with chronic pain may hold promise for enhancing their resilience and quality of life.
引用
收藏
页码:106 / 119
页数:14
相关论文
共 59 条
[1]   Integrating the Influence of Sex and Gender in Research: Keeping Women Veterans in Focus [J].
Bevans, Margaret ;
Clayton, Janine A. .
WOMENS HEALTH ISSUES, 2019, 29 :S9-S11
[2]   Conceptualizing and Treating Comorbid Chronic Pain and PTSD [J].
Bosco, Michelle A. ;
Gallinati, Jessica L. ;
Clark, Michael E. .
PAIN RESEARCH AND TREATMENT, 2013, 2013
[3]   Development and validation of the Pain Outcomes Questionnaire-VA [J].
Clark, ME ;
Gironda, RJ ;
Young, RW .
JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT, 2003, 40 (05) :381-395
[4]  
Cohen J., 1988, STAT POWER ANAL BEHA
[5]   An Online Mindfulness Intervention Targeting Socioemotional Regulation in Fibromyalgia: Results of a Randomized Controlled Trial [J].
Davis, Mary C. ;
Zautra, Alex J. .
ANNALS OF BEHAVIORAL MEDICINE, 2013, 46 (03) :273-284
[6]   Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care [J].
Denison, E ;
Åsenlöf, P ;
Lindberg, P .
PAIN, 2004, 111 (03) :245-252
[7]   Posttraumatic stress disorder in female veterans - Association with self-reported health problems and functional impairment [J].
Dobie, DJ ;
Kivlahan, DR ;
Maynard, C ;
Bush, KR ;
Davis, TM ;
Bradley, KA .
ARCHIVES OF INTERNAL MEDICINE, 2004, 164 (04) :394-400
[8]   Trauma, Social Support, Family Conflict, and Chronic Pain in Recent Service Veterans: Does Gender Matter? [J].
Driscoll, Mary A. ;
Higgins, Diana M. ;
Seng, Elizabeth K. ;
Buta, Eugenia ;
Goulet, Joseph L. ;
Heapy, Alicia A. ;
Kerns, Robert D. ;
Brandt, Cynthia A. ;
Haskell, Sally G. .
PAIN MEDICINE, 2015, 16 (06) :1101-1111
[9]   The Role of Psychosocial Processes in the Development and Maintenance of Chronic Pain [J].
Edwards, Robert R. ;
Dworkin, Robert H. ;
Sullivan, Mark D. ;
Turk, Dennis C. ;
Wasan, Ajay D. .
JOURNAL OF PAIN, 2016, 17 (09) :T70-T92
[10]   Cognitive-Behavioral Therapy for Individuals With Chronic Pain Efficacy, Innovations, and Directions for Research [J].
Ehde, Dawn M. ;
Dillworth, Tiara M. ;
Turner, Judith A. .
AMERICAN PSYCHOLOGIST, 2014, 69 (02) :153-166