The effects of a multidimensional treatment programme within a cognitive-behavioural hypnotherapeutic framework for sufferers of Fibromyalgia

Miller, Tania (2000-12)

Thesis (M.A.)--Stellenbosch University, 2000.

Thesis

ENGLISH ABSTRACT: In this study, a Multiple Baseline across People design was used with a sample of 6 Fibromyalgia (FS) sufferers in order to evaluate the efficacy of a multidimensional treatment programme on: pain intensity, duration of pain experiences and intake of medication. The programme which consisted of weekly 2 hourly sessions over a period of 6 weeks, combined hypnotherapy and self-hypnosis with cognitive-behavioural techniques. Attempts were made to customise interventions to the specific needs of the individual. The following three hypotheses were postulated: That introduction of the treatment programme would: 1) reduce pain intensity levels; 2) reduce the duration of pain experiences (average daily pain hours) thus minimising the interference of pain into the lives of the patients; 3) reduce the intake of medication. All three of the hypotheses are supported by the results. Graphs show that pain intensity levels, average daily pain hours (duration) and intake of medication clearly decreased over the treatment process from baseline to follow up. For hypotheses 1 and 2, the Wilcoxon Signed Ranks Test was applied which showed that the results were also statistically significant. The study yielded qualitative information regarding two areas of FS: 1) possible etiological factors contributing towards the syndrome; 2) the elucidation of various therapeutic components responsible for alleviating specific FS symptoms. In particular, the study highlights the importance of targeting maladaptive cognitions linked to pain experiences as well as of taking account of individual interpersonal issues in the management of FS sufferers. An etiological model is presented by the author which views FS within a systemic framework III which vanous variables (psychological and physiological) operating at the individual, environmental and socio-cultural levels, interact to produce the syndrome.

AFRIKAANSE OPSOMMING: In hierdie studie is van 'n Meervoudige Basislynontwerp met Mense (''Multiple Baseline across People") gebruik gemaak om 'n steekproef van 6 Fibromialgie (FS) pasiente te evalueer ten opsigte van pynintensiteit, tydsduur van pynervarings en die inneem van medikasie. Die program, 'n kombinasie van hipnose met kognitiewe gedragstegnieke, het bestaan uit weeklikse sessies van 2 ure elk oor 'n tydperk van 6 weke. Die intervensies wat plaasgevind het, was ook gerig op die spesifieke behoeftes van die individu. Die volgende drie hipoteses IS gestel, naamlik dat die toepassing van die behandelingsprogram sou: 1) die pyn-intensiteitsvlakke verminder; 2) die tydsduur van die pyn-ervarings verminder en die voorkoms van pyn in die pasient se lewe minimaliseer; 3) die inname van medikasie verminder. Al drie hipoteses is betekenisvolondersteun deur die resultate. Die statistiese grafieke het getoon dat die pyn-intensiteitsvlakke, die gemiddelde daaglikse pyn-ervaringsure en die inname van medikasie, betekenisvol verminder het oor die behandelingsperiode vanaf basislyn tot opvolgperiode. Die ''Wilcoxon Signed Ranks Test" het ten opsigte van hipoteses 1 en 2 ook statisties betekenisvolle resultate aangetoon. Die kwalitatiewe inligting vanuit die ondersoek bekom, het twee aspekte rakende FS navore gebring, naamlik: 1) die moontlike etiologiese faktore wat bedra tot die sindroom en 2) 'n duideliker omlyning van die terapeutiese komponente verantwoordelik vir die versagting van spesifieke FS simptome. In besonder is die wanaangepaste kognisies geassosieer met pynervanrings uitgelig, asook die interpersoonlike probleme wat FS pasiente ervaar in die behandelingsprogram. 'n Etiologiese model, wat FS binne 'n sisterniese raamwerk plaas, IS deur die navorser voorgestel. Laasgenoemde model spreek die verskeidenheid van sielkundige en fisiologiese veranderlikes, wat op die individu, omgewing en sosiokulturele vlakke inwerk, op so 'n wyse aan dat dit die sindroom meer verklaarbaar maak.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/51972
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