ABSTRACT
STUDY DESIGN: Single-group feasibility clinical trial. OBJECTIVES: This study examined the feasibility and outcomes of a modified version of a validated internet-delivered pain management programme, the Pain Course, for adults with SCI. SETTING: Nationwide in Australia. METHODS: Sixty-eight adults participated in the programme, which comprises five online lessons and homework tasks that are systematically released over 8 weeks. Participants were supported through the course with weekly contact from a clinical psychologist. RESULTS: Eighty-five percent of participants provided data at post-treatment and 76% of participants completed all five lessons of the course. High levels of satisfaction were observed and relatively little clinician time (M = 93.16 min; SD = 52.76 min) was required per participant to provide the course. Preliminary evidence of clinical improvements in pain-related disability (ds ≥ 0.53.; avg. improvement ≥ 20%; Mdiff ≥ 7.77), depression (ds ≥ 0.44.; avg. improvement ≥ 24%; Mdiff ≥ 2.44), anxiety (ds ≥ 0.41.; avg. improvement ≥ 26%; Mdiff ≥ 1.8) and average pain intensity (ds ≥ 0.46.; avg. improvement ≥ 13%; Mdiff ≥ 0.71) were observed at post-treatment, which were maintained or further improved to 3-month follow-up. These improvements were reflected in overall improvements in self-reported satisfaction with life (ds ≥ 0.31; avg. improvement ≥ 25%; Mdiff ≥ 2.16) CONCLUSION: These findings highlight the potential of carefully developed internet-delivered interventions as an approach for overcoming barriers and increasing access to psychosocial care for adults with SCI. SPONSORSHIP: iCare Lifetime Care and Support Authority and the Australian National Health and Medical Research Council.
Subject(s)
Internet , Pain Management/methods , Spinal Cord Injuries/therapy , Telemedicine , Therapy, Computer-Assisted , Adult , Aged , Aged, 80 and over , Anxiety/therapy , Depression/therapy , Feasibility Studies , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Patient Acceptance of Health Care , Patient Satisfaction , Prospective Studies , Spinal Cord Injuries/psychology , Telemedicine/methods , Therapy, Computer-Assisted/methods , Treatment Outcome , Young AdultABSTRACT
In Part I of this paper, "Intensive care of the Crush victim" (1) Gayle Burr presented the mechanism of crush injury and the pathophysiology underlying the clinical manifestations of the crush syndrome, its assessment and management. Part II outlines the case study of John who was trapped for 10-12 hours following a motor vehicle accident. A chronological overview of the events in this case will be described. The medical management and nursing implications of each of his presenting complications will be discussed.
