@文章{信息:doi/10.2196/17293，作者=“Darnall, Beth D和Krishnamurthy, Parthasarathy和Tsuei, Jeannette和Minor, Jorge D”，标题=“基于自我管理技能的虚拟现实干预慢性疼痛:随机控制的初步研究”，期刊=“JMIR Form Res”，年=“2020”，月=“七月”，日=“7”，卷=“4”，数=“7”，页=“e17293”，关键词=“慢性疼痛;虚拟现实;行为医学;自我管理;移动电话;背景:慢性疼痛患者通常获得包括行为疼痛管理策略在内的综合护理的机会有限。虚拟现实(VR)是一种沉浸式技术和新兴的数字行为疼痛疗法，对急性疼痛具有镇痛效果。我们没有发现针对慢性疼痛人群的基于技能的VR行为程序的科学文献。目的:本研究的主要目的是评估自我管理的VR程序的可行性，该程序包括基于证据的行为治疗慢性疼痛的内容和技能。次要目的是确定VR计划的初步疗效，包括平均疼痛强度和疼痛对活动、压力、情绪和睡眠的干扰，以及它对疼痛相关认知和自我效能的影响。 The tertiary aim was to conduct a randomized controlled trial (RCT) and compare the VR treatment with an audio-only treatment. This comparison isolated the immersive effects of the VR program, thereby informing potential mechanisms of effect. Methods: We conducted an RCT involving a web-based convenience sample of adults (N=97) aged 18-75 years with self-reported chronic nonmalignant low back pain or fibromyalgia, with an average pain intensity >4 over the past month and chronic pain duration >6 months. Enrolled participants were randomly assigned to 1 of 2 unblinded treatments: (1) VR: a 21-day, skills-based VR program for chronic pain; and (2) audio: an audio-only version of the 21-day VR program. The analytic data set included participants who completed at least 1 of 8 surveys administered during the intervention period: VR (n=39) and audio (n=35). Results: The VR and audio groups launched a total of 1067 and 1048 sessions, respectively. The majority of VR participants (n=19/25, 76{\%}) reported no nausea or motion sickness. High satisfaction ratings were reported for VR (n=24/29, 83{\%}) and audio (n=26/33, 72{\%}). For VR efficacy, symptom improvement over time was found for each pain variable (all P<.001), with results strengthening after 2 weeks. Importantly, significant time{\texttimes}group effects were found in favor of the VR group for average pain intensity (P=.04), pain-related inference with activity (P=.005), sleep (P<.001), mood (P<.001), and stress (P=.003). For pain catastrophizing and pain self-efficacy, we found a significant declining trend for both treatment groups. Conclusions: High engagement and satisfaction combined with low levels of adverse effects support the feasibility and acceptability of at-home skills-based VR for chronic pain. A significant reduction in pain outcomes over the course of the 21-day treatment both within the VR group and compared with an audio-only version suggests that VR has the potential to provide enhanced treatment and greater improvement across a range of pain outcomes. These findings provide a foundation for future research on VR behavioral interventions for chronic pain. ", issn="2561-326X", doi="10.2196/17293", url="https://formative.www.mybigtv.com/2020/7/e17293", url="https://doi.org/10.2196/17293", url="http://www.ncbi.nlm.nih.gov/pubmed/32374272" }