Effekt av kognitiv atferdsterapi via Internett til behandling av kronisk smerte hos barn og ungdom: Systematisk oversikt og metaanalyse

Efficacy of Internet-delivered cognitive-behavioral therapy for the management of chronic pain in children and adolescents: A systematic review and meta-analysis

Forfattere
Tang, W. X. Zhang, L. F. Ai, Y. Q. Li, Z. S.
Årstall
2018
Tidsskrift
Medicine
Volum
97
Sider
e12061
BACKGROUND: Pediatric chronic pain is relatively common in the world. Although cognitive behavior therapy (CBT) has been shown to be efficacious in children and adolescents, it is generally recognized that availability and accessibility of CBT are limited. While Internet-delivered cognitive-behavioral therapy (ICBT) performs better in these areas. OBJECTIVES: This systematic review aims to evaluate the clinical effects of ICBT for chronic pain in youth when compared with the control treatments. METHODS: We searched electronic databases to identify randomized controlled trials that compared ICBT with the control therapy for pediatric chronic pain. The primary outcomes were 95% confidence intervals and mean difference or standardized mean difference in change of pain intensity and activity limitations. RESULTS: Four trials met the inclusion criteria with a total of 404 participants of whom 208 received ICBT. Compared with pretreatment, children reported significant, medium to large benefits on pain intensity, activity limitations, and parental protective behaviors after receiving ICBT immediately. Significant small to medium effects were found for outcomes of depressive symptoms, anxiety, and sleep quality from baseline to post-treatment in the ICBT group. But most measures of ICBT did not show statistically significant superiority to those of the control conditions, except parental protective behaviors. Generally children and their parents were highly acceptable and satisfied with ICBT. CONCLUSION: ICBT for physical and psychological conditions in youth with chronic pain is a full potential therapy; it can be successful on clinically effects and socioeconomic benefits. However, only limited data supported the conclusion, we require further methodologically robust trials. Systematic review registration: Prospero crd42017069811.

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Tiltaksnivå

Tidlig innsats

Behandling og hjelpetiltak

Tema

Biologiske risikofaktorer, sykdommer og symptomer

Somatisk sykdom (inkl. smertetilstander)

Tiltak

Psykologiske behandlingsmetoder

Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi

Organisering av tiltak

E-helsetiltak (spill, internett, telefon)

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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