The value of focusing : a psychological self-help strategy when living with chronic low back pain : a mixed methods study
Notice bibliographique
Résumé
Chronic low back pain (CLBP) is a widespread and disabling condition affecting many thousands of people in the UK, causing distress in many areas of their lives. Most people with CLBP do not have access to specialist advice and resort to managing it themselves. The government drive to encourage people to manage their own long-term conditions has led to some work on the use of self-help techniques with CLBP. However little research has been done with CLBP populations who are not seeking specialist advice. This study actively sought people from this population group. Focusing - a self-help technique based on the client-centred psychological approach - was introduced to two people who had long-term CLBP. In addition two people who had been using Focusing in their lives for some time and have long-term CLBP (but have not applied Focusing to that problem) were also recruited. Focusing was taught either face-to-face or by telephone for six weekly hour-long sessions; the experienced Focusers spent an hour each week for six weeks Focusing with their pain. Using a mixed methods approach the four participants were interviewed a number of times, namely before, immediately after and three to six months following the Focusing sessions. They also completed the WHOQOL-PainUK questionnaire, the short-form McGill Pain Questionnaire and a global QOL measure at these three times. During the Focusing sessions they completed the SF-MPQ and the global QOL weekly. Within the concurrent nested design the qualitative aspect formed the theoretical driver for the study; the quantitative element providing a smaller amount of data. This enabled the findings to be framed in a way which makes them accessible to the wide range of healthcare professionals involved in the management of CLBP; an approach described as one of 'utility'. The management of potential incongruencies in using a mixed method approach was a continuous theme throughout the study and a model - the context of stability model - was devised to enable a harmonisation of these in the study design.During the study three of the four participants reported a change in the meaning of their pain, and improvement in the perception of their pain and its impact. After using Focusing with their CLBP participants reported that the pain no longer controlled what they did, they were able to feel more 'themselves' and value themselves and Focusing had given them a supported place to talk about their pain. Focusing appears to have an impact for these people in enabling the acceptance of CLBP and an improvement in overall quality of life was found. The physical, psychological and independence quality of life domains in particular showed sustained improvement. No negative side effects were noted by any of the participants. Further study is needed to demonstrate whether the use of Focusing with CLBP confers longer term benefits and is suitable for a wider range of people.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,014 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».