基于互联网的引发性外阴痛治疗：与治疗结果相关的因素

Internet-based treatment for provoked vulvodynia: factors associated with treatment outcomes

——《性医学杂志》2025年第22卷第1期——

<The Journal of Sexual Medicine> Volume 22, Issue 1, 2025 

      【摘要】引言：先前的研究表明，基于互联网的接受和承诺治疗（ACT）可以减弱性交时的疼痛，并提高诱发性外阴痛患者的疼痛接受度，但与治疗结果相关的因素仍然未知。目的：本研究旨在调查基于ACT的互联网治疗后疼痛接受度相关的因素。方法：本探索性研究使用了EMBLA研究的数据，这是一项多中心随机对照试验，研究了基于互联网的ACT对诱发性外阴痛的影响。检查的因素包括社会人口统计学、疾病史、疼痛和性行为以及社会心理特征。采用线性回归分析来评估这些因素与疼痛接受度之间的关联，包括回答。邦费罗尼校准对结果进行了检验。结果测量：结果测量是根据《慢性疼痛标准修订版》量表评估的疼痛接受度，该量表包含两个子量表：活动参与度和疼痛接受度。结果：调整前，有身体暴力或性侵犯史的参与者组参与者在整体疼痛接受度和活动参与度方面有所改善。每周在治疗平台上花费的时间越多，疼痛接受度的改善也越大。受互联​行为的互联网治疗后治疗结果相关的因素，尤其是疼痛方面，之前的暴力和性侵犯、同时出现胃肠道或泌尿问题以及坚持治疗。优势和局限性：这是一项新颖的探索性研究，为研究人员未来研究个人特征如何影响治疗结果提供了信息。模型中探索了一系列变量，强调了未来研究对加强研究结果的重要性。一个限制是样本，考虑到研究的性质，样本量相当小。结论：经过样本检验校正后，未发现任何变量与治疗后接受度的变化具有统计学相关性。

      【关键词】基于互联网的治疗，引发结果性外阴痛，接受和承诺治疗，相关因素，治疗

        [Abstract] Introduction: Previous research has indicated that internet-based Acceptance and Commitment Therapy (ACT) can reduce pain during intercourse and increase pain acceptance in individuals with provoked vulvodynia, but the factors associated with treatment outcomes remain unknown. Aim: This study aimed to investigate factors associated with changes in pain acceptance following an internet treatment based on ACT. Methods: This exploratory study used data from the EMBLA study, a multicenter randomized controlled trial that investigated the effects of internet-based ACT for provoked vulvodynia. The examined factors included sociodemographics, medical history, pain and sexual behavior, and psychosocial characteristics. Linear regression analysis was employed to assess the association of these factors with pain acceptance, including interaction effects. Results were adjusted for multiple testing using Bonferroni correction. Outcomes: The outcome measure was pain acceptance assessed on the scale Chronic Pain Questionnaire–Revised, which comprises two sub-scales: activity engagement and pain willingness.  Results:  Before adjustment, greater improvement in overall pain acceptance and the subscale activity engagement was seen participants in the intervention group who had a history of physical violence or sexual assault. Increased time spent on the treatment platform per week was also associated with greater improvement in pain acceptance. Participants who reported gastrointestinal problems before the internet-based treatment showed better treatment outcomes in activity engagement. Previous contact with a psychologist or counselor was associated with less improvement in activity engagement. The intervention was less effective on the subscale pain willingness with increased age and for those reporting urinary problems. No associations remained statistically significant after adjustment for multiple testing. Clinical implications: Previous exposure to violence and sexual assault, concomitant gastrointestinal or urinary problems, and adherence to treatment should be further investigated in larger studies on factors associated with treatment outcomes after internet treatment based on ACT, especially regarding pain. Strengths and limitations: This was a novel and exploratory study and provides information for researchers in future investigations of how individual characteristics may influence treatment outcomes. A range of variables were explored in the models, underscoring the importance of future studies to strengthen the findings. One limitation concerns the sample size, which was fairly small considering the nature of the study. Conclusion: After correcting for multiple testing, no factors were found to be statistically associated with changes in pain acceptance after the treatment.

        [Key words] internet-based treatment, provoked vulvodynia, ACT, associated factors, treatment outcomes

        论文原文：Andrea Hess Engström, Ida Flink, Viktoria Kero, Nina Bohm-Starke, Alkistis Skalkidou (2025). Internet-based treatment for provoked vulvodynia: factors associated with treatment outcomes. The Journal of Sexual Medicine, Volume 22, Issue 1, Pages 107–113, January 2025.

https://doi.org/10.1093/jsxmed/qdae158 

（需要英文原文的朋友，请联系微信：millerdeng95或iacmsp）