| IntroductionLow back pain is one of main causes for medical use. But the pain remission rates of various conventional methods, internal or surgical, are among 30% to 67%. So people have been looking for the causes that affect the outcome of low back pain treatment, among which psychological factors play an important role.The roles of psychological factors present in every sector of pain, and compared to medical and biodynamic factors, it's more often and easy for psychological factors to cause disability. Psychological factors include negative emotions, ( such as depression and anxiety) , dysfunctional cognitions, ( such as belief for pain, cognitive strategy, fear-avoid reaction) , and negative coping style (catarstrophizing). In order to decrease the influence of psychological factors, behavior therapy (BT) and cognitive -behavior (CBT) therapy were applied in clinical pain treatment and positive outcomes were yielded. Several high quality reviews show that BT or CBT are effective in pain report\ severity, affections, daily function, pain behavior and coping style.The purpose of this trail is to study the effect of brief cognitive -behavior therapy composed of psychological support and education, relaxation training and biofeedback training on patient mental stress a-round the operation time, and observe the follow - up outcome 3 months later.Material and MethodObject; 64 inpatients in the department of Orthopedics of No. 2 Hospital of China Medical University from Sep. 2001 to Sep. 2002 were included, whose {Self- reported Depress Scale^(SDS) > =53 or (Self-reported Anxiety Scale}(SAS) > =50, and patients were randomly classified to experimental group and control group. Method: From the day the patient came into the hospital, the experimental group was offered;Psychological support and educationRelaxation and biofeedback trainingProcedureAll patients filled in the SAS, SDS and medical record of hospi-talization, and selected the patients whose SAS > = 50, or SDS > = 53.Check the experimental patients twice everyday.Give the experimental patients 30 minutes relaxation and biofeedback training once a day before and after operation. During operation, psychologist followed the patient to operation room and offer intervention from time anesthesia succeeded to the end.All patients filled in the SAS, SDS again before leaving the hospital.3 months later, the follow - up letters were posted patients to invited them to hospital for re - examination, telephone or letter were used for those cant come to hospital themselves.Parameters4.1 Degree of nervous;A: VAS of nervous (1-10)B: VAS of pain (1-10)C: Sleeping time (h\d)D: Heart rate, blood pressure (mmHg)F: EMG4.2 Chang of Emotion: SAS, SDS4.3 Situations of follow up: Complains and signs, the degree of pain relief (1 - 100) % , the satisfactory degrees on therapy ( 1 -100)% , walk ability and daily life(1 - 100)% , degree of fear - a-voidance( 1 - 100) % , degree of back work and interpersonal relationship ( 1 - 100) % , and the belief of recovery(1 - 100) % .ResultThe scores of SAS and SDS of both experimental and control group descended respectively as time went on, and compared which the first day in hospital, SAS became obviously descent before discharge, and so did SDS at follow up time. But SAS of experimental group was significandy lower than the control group whether before discharge or at follow up, and so did the SDS at follow up.The analogical score of tension of experimental group was lower obviously than the control group on the day before operation, operation day, 2 days and 3 days after operation; the analogical score of pain lower on operate day and 3 days after operate; time of sleep did not show obvious difference from that of control group; the heart rate of experimental was less than control on operate day and 1 day after operate ; blood pressure significandy lower on operate day and 3 days after operate; and EMG significandy lower on 1st day, 2nd days and 3rdd... |
