Turner J A, Jensen M P, Romano J M
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 356560, Seattle, USA.
Pain. 2000 Mar;85(1-2):115-25. doi: 10.1016/s0304-3959(99)00259-6.
Physical and psychosocial disability in patients with chronic pain have been shown to be associated with patients' pain-related beliefs, tendency to catastrophize, and pain coping strategy use. However, little is known about whether beliefs, catastrophizing, and coping strategies are independently associated with patient adjustment. Identification of specific beliefs, cognitive responses, and coping strategies strongly and independently associated with physical and psychosocial functioning would suggest the importance of targeting those variables for modification in treatment. One hundred sixty-nine patients entering a multidisciplinary pain treatment program completed measures of pain, beliefs, coping, catastrophizing, physical disability, and depression. Principal components analyses were used to create belief and coping components, which were then entered in multiple regression analyses predicting physical disability and depression. Belief scores significantly and independently predicted both physical disability and depression, after controlling for age, sex, pain intensity, catastrophizing, and coping. Coping scores significantly and independently predicted physical disability, but not depression, whereas catastrophizing independently predicted depression, but not physical disability. These findings suggest the importance of targeting specific pain-related beliefs and coping strategies, as well as catastrophizing, for modification in the treatment of patients with chronic pain.
慢性疼痛患者的身体和心理社会残疾已被证明与患者与疼痛相关的信念、灾难化倾向以及疼痛应对策略的使用有关。然而，对于信念、灾难化和应对策略是否与患者的适应能力独立相关，我们知之甚少。识别与身体和心理社会功能密切且独立相关的特定信念、认知反应和应对策略，将表明在治疗中针对这些变量进行调整的重要性。169名进入多学科疼痛治疗项目的患者完成了疼痛、信念、应对、灾难化、身体残疾和抑郁的测量。主成分分析用于创建信念和应对成分，然后将其纳入预测身体残疾和抑郁的多元回归分析中。在控制了年龄、性别、疼痛强度、灾难化和应对因素后，信念得分显著且独立地预测了身体残疾和抑郁。应对得分显著且独立地预测了身体残疾，但不能预测抑郁，而灾难化则独立地预测了抑郁，但不能预测身体残疾。这些发现表明，在慢性疼痛患者的治疗中，针对特定的与疼痛相关的信念、应对策略以及灾难化进行调整具有重要意义。
