y for reducing pain intensity, pain catastrophizing, and opioid cessation up to 3 months after surgery. METHODS: A randomized controlled clinical trial was conducted at an orthopedic trauma surgery unit at a major academic hospital to compare a digital behavioral pain management intervention (“My Surgical Success” [MSS]) to a digital general health education (HE) intervention (HE; no pain management skills). The enrolled sample included 133 patients; 84 patients were randomized (MSS, n = 37; HE, n = 47) and completed study procedures. Most patients received their assigned intervention within 3 days of surgery (85%). The sample was predominantly male (61.5%), White (61.9%), and partnered (65.5%), with at least a bachelor’s degree (69.0%). Outcomes were collected at 1–3 months after intervention through self-report e-surveys and electronic medical record review; an intention-to-treat analytic framework was applied. Feasibility was dually determined by the proportion of patients engaging in their assigned treatment and an application of an 80% threshold for patient-reported acceptability. We hypothesized that MSS would result in greater reductions in pain intensity and pain catastrophizing after surgery and earlier opioid cessation compared to the digital HE control group. RESULTS: The engagement rate with assigned interventions was 63% and exceeded commonly reported rates for fully automated Internet-based e-health interventions. Feasibility was demonstrated for the MSS engagers, with >80% reporting treatment acceptability. Overall, both groups improved in the postsurgical months across all study variables. A significant interaction effect was found for treatment group over time on pain intensity, such that the MSS group evidenced greater absolute reductions in pain intensity after surgery and up to 3 months later (treatment × time fixed effects; F[215] = 5.23; P = .024). No statistically significant between-group differences were observed for time to opioid cessation or for reductions in pain catastrophizing (F[215] = 0.20; P = .653), although the study sample notably had subclinical baseline pain catastrophizing scores (M = 14.10; 95% confidence interval, 11.70–16.49). CONCLUSIONS: Study findings revealed that a fully automated behavioral pain management skills intervention (MSS) may be useful for motivated orthopedic trauma surgery patients and reduce postsurgical pain up to 3 months. MSS was not associated with reduced time to opioid cessation compared to the HE control intervention....

中文翻译：

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“我的手术成功”：单次数字行为疼痛医学干预对骨科创伤手术后疼痛强度、疼痛灾难性和阿片类药物戒断时间的可行性和影响——一项随机试验

y 用于减轻疼痛强度、疼痛灾难性以及术后 3 个月内停止阿片类药物。方法：在一家大型学术医院的骨科创伤外科单位进行了一项随机对照临床试验，以比较数字化行为疼痛管理干预措施（“我的手术成功”[MSS]）与数字化普通健康教育（HE）干预措施（HE） ；没有疼痛管理技能）。纳入样本包括133名患者；84 名患者被随机分组​​（MSS，n = 37；HE，n = 47）并完成研究程序。大多数患者 (85%) 在手术后 3 天内接受指定的干预措施。样本主要是男性（61.5%）、白人（61.9%）和有伴侣（65.5%），至少拥有学士学位（69.0%）。通过自我报告电子调查和电子病历审查，在干预后 1-3 个月收集结果；应用了意向治疗分析框架。可行性由参与指定治疗的患者比例和患者报告可接受性的 80% 阈值的应用来双重确定。我们假设与数字 HE 对照组相比，MSS 会导致手术后疼痛强度和灾难性疼痛的更大程度降低以及更早停止阿片类药物。结果：指定干预措施的参与率为 63%，超过了通常报告的基于互联网的全自动电子健康干预措施的参与率。MSS 参与者的可行性得到了证明，超过 80% 的人报告治疗可接受。总体而言，两组患者在术后几个月的所有研究变量均有所改善。随着时间的推移，治疗组对疼痛强度存在显着的交互作用，因此 MSS 组在手术后和 3 个月后的疼痛强度绝对降低幅度更大（治疗 × 时间固定效应；F[215] = 5.23；P =.024）。尽管研究样本明显具有亚临床基线疼痛灾难化评分（M = 14.10；P = .653），但在阿片类药物戒断时间或疼痛灾难化减少方面没有观察到统计学显着差异（F[215] = 0.20；P = .653）。 95% 置信区间，11.70–16.49）。结论：研究结果表明，全自动行为疼痛管理技能干预 (MSS) 可能对有动力的骨科创伤手术患者有用，并可减少术后疼痛长达 3 个月。与 HE 对照干预相比，MSS 与阿片类药物戒断时间的缩短无关……