지역사회 내 고령 흑인 성인의 만성 통증-우울증 공존질환에 대한 마음챙김 인지치료; Quiet Focus 오픈 파일럿 연구

실험적: 마음챙김 인지치료

행동: Mindfulness-based cognitive therapy

The delivered intervention is mindfulness-based cognitive therapy adapted for the chronic pain and depression among older Black adults. Mindfulness-based cognitive therapy (MBCT) is a structured psychotherapy that integrates mindfulness practices with cognitive behavioral therapy techniques. This adapted MBCT is delivered as an 8-week group-based program with each weekly session lasting about 1 hour. Sessions occur once per week, supplemented by daily home practice of 40-60 minutes, 6 days a week, involving guided meditations, body scans, and mindful activities to reinforce skills.

클라이언트 만족도 설문지

3항목 버전의 클라이언트 만족도 설문지(CSQ-3)는 세 가지 핵심 항목의 응답을 합산하여 점수를 매깁니다.
이는 서비스 만족도의 주요 측면을 측정하는 경험적으로 선정된 항목들로 구성되며, 각 항목은 4점 리커트 척도(1=최저 만족도, 4=최고 만족도, 필요에 따라 방향성이 조정됨)로 평가됩니다.
총점은 3점에서 12점까지이며, 높은 점수는 더 큰 만족도를 나타냅니다; 역코딩이나 하위 척도는 필요하지 않습니다.

The Credibility and Expectancy Questionnaire

The Credibility/Expectancy Questionnaire (CEQ) is a 6-item self-report measure assessing treatment credibility (items 1-3) and expectancy (items 4-6). Items 1-3 and 5 are rated 0 (not at all credible/logical) to 9 (extremely credible/logical), while items 4 and 6 are rated 0% to 100%; subscale scores are standardized and summed (credibility: 3-27 raw equivalent; expectancy similar), with total scores ranging 6-54 after standardization, where higher scores indicate greater credibility and positive outcome expectancy (better outcome).

Modified Patient Global Impression of Change

The Modified Patient Global Impression of Change (mPGIC) adapts the standard single-item Patient Global Impression of Change (PGIC), a validated patient-reported outcome measure of overall perceived change since intervention, by assessing change across six specific domains. Each domain uses a single ordinal item rated on a 7-point scale, coded from 1 = Very Much Improved to 7 = Very Much Worse. Lower scores indicate greater perceived improvement. Domains include coping strategies, physical activity, social activity, level of stress, memory and thinking, and pain, and are analyzed separately.

수치 평가 척도

통증 강도에 대한 수치 평가 척도(NRS)는 0(통증 없음)에서 10(상상할 수 있는 최악의 통증)까지의 11점 척도로, 지난주 동안의 평균 통증을 평가합니다. 높은 점수는 더 큰 통증 강도(더 나쁜 결과)를 나타내며, 낮은 점수는 더 적은 통증(더 좋은 결과)을 나타냅니다; 단일 항목 총 점수입니다.

PROMIS 불안

PROMIS 단축형 V1.0 - 정서적 고통 불안 8a(PROMIS Anxiety SF 8a v1.0)는 지난 7일 동안의 자가 보고 불안 증상을 평가하는 8문항의 환자 보고 결과 측정 도구로, 두려움, 긴장, 걱정, 공포, 긴장하거나 안절부절 못하는 느낌 등을 포함합니다. 각 문항마다 5점 리커트 응답 척도를 사용합니다: 전혀 없음(1), 거의 없음(2), 가끔(3), 자주(4), 항상(5). 원점수 총점 범위는 8(최소 불안, 최상 결과)에서 40(심각한 불안, 최악 결과)까지이며, 이는 채점표를 통해 T-점수(미국 인구 기준 평균=50, 표준편차=10)로 변환됩니다. 여기서 더 높은 T-점수는 더 심각한 불안을 나타냅니다. 하위 척도는 계산되지 않으며, 총점이 전반적인 불안 고통을 반영합니다. T-점수 범위: 8a 단축형의 경우 28-82입니다.

PROMIS Physical Function

The PROMIS Short Form V2.0 - Physical Function 8B (PROMIS PF 8B v2.0) is an 8-item patient-reported outcome measure assessing self-reported capability in physical activities, including upper extremity function (e.g., hand/arm tasks), lower extremity function (e.g., walking), central body function, and daily activities. It uses a 5-point Likert response scale per item: Without any difficulty (5), With little difficulty (4), With some difficulty (3), With much difficulty (2), or Unable to do/Cannot do (1). Raw total scores range from 8 (severe difficulty, worst outcome) to 40 (no difficulty, best outcome); these convert via scoring tables to T-scores (mean=50, SD=10 in U.S. population), where higher T-scores indicate better physical function. No subscales are computed; the total score reflects overall physical function. The T-score range for the PROMIS SF V1.2 is 10-65.

PROMIS Depression

The PROMIS Short Form V1.0 - Emotional Distress Depression 8b (PROMIS Depression SF 8b v1.0) is an 8-item patient-reported outcome measure assessing self-reported depressive symptoms over the past 7 days, including feelings of worthlessness, helplessness, sadness, failure, depression, unhappiness, and hopelessness. It uses a 5-point Likert response scale per item: Never (1), Rarely (2), Sometimes (3), Often (4), or Always (5). Raw total scores range from 8 (minimal depression, best outcome) to 40 (severe depression, worst outcome); these convert via scoring tables to T-scores (mean=50, SD=10 in U.S. population), where higher T-scores indicate greater depression severity. No subscales are computed; the total score reflects overall depressive distress. T-score range: 42-84.

PROMIS Emotional Support

The PROMIS Short Form V2.0 - Emotional Support 8a (PROMIS Emotional Support SF 8a v2.0) is an 8-item patient-reported outcome measure assessing perceived availability of supportive interpersonal relationships over the past 7 days, including listening, confiding, appreciation, understanding, and trust. It uses a 5-point Likert response scale per item: Never (1), Rarely (2), Sometimes (3), Often (4), or Always (5). Raw total scores range from 8 (minimal support, worst outcome) to 40 (strong support, best outcome); these convert via scoring tables to T-scores (mean=50, SD=10 in U.S. population), where higher T-scores indicate greater emotional support. No subscales are computed; the total score reflects overall perceived support. T-score range: 25-75 for the 8a short form.

Measure of Current Status Part A

The Measure of Current Status Part A (MOCS-A) is a self-report questionnaire that measures ability to manage stress. The Measure of Current Status Part A (MOCS-A) comprises 13 items rated 0 (cannot do at all) to 4 (extremely well), summed for total score 0-52, with four subscales: relaxation, tension awareness, assertiveness, coping confidence (higher total/subscale scores indicate better stress management ability, better outcome). Each item is rated on a 5-point Likert scale where 0 = "I cannot do this at all" and 4 = "I can do this extremely well," with higher scores reflecting greater confidence in coping skills.

Cognitive and Affective Mindfulness Scale-Revised

The Cognitive and Affective Mindfulness Scale-Revised (CAMS-R) is a 12-item scale rated 1 (rarely/not at all) to 4 (almost always), total score summed 12-48 (higher scores indicate greater mindfulness ability, better outcome); unidimensional total score. Scoring: Items 2, 6, and 7 are reverse-scored. After appropriate reversals, sum values for items 1-12. Higher values reflect greater mindful qualities.

Chronic Pain Acceptance Questionnaire

The Chronic Pain Acceptance Questionnaire (CPAQ) sums 20 items rated 0 (never true) to 6 (always true) for total raw score 0-120, with two subscales: Activity Engagement (0-66) and Pain Willingness (0-54), both/totals higher indicating greater pain acceptance (better outcome).

Pain Self-Efficacy Questionnaire

The Pain Self-Efficacy Questionnaire (PSEQ) consists of 10 items rated 0 (not at all confident) to 6 (completely confident), summed for total 0-60. Higher scores indicate greater self-efficacy despite pain (better outcome); single total score.

Pain Catastrophizing Scale

The Pain Catastrophizing Scale (PCS) sums 13 items rated 0 (not at all) to 4 (all the time) for total 0-52, with subscales: Rumination (0-16), Magnification (0-12), Helplessness (0-24); higher scores indicate greater catastrophizing (worse outcome).

Tampa Kinesiophobia Scale

The Tampa Scale of Kinesiophobia (TSK-17) sums 17 items rated 1 (strongly disagree) to 4 (strongly agree), with reverse on items 4, 8, 12, and 16. Total score range: 17-68 (higher scores greater kinesiophobia/fear of movement, worse outcome).