LaChapelle D L, Hadjistavropoulos H D, McCreary D R, Asmundson G J
Clinical Research and Development Program, Regina Health District and Department of Psychology, University of Regina, Regina, Saskatchewan, Canada.
Eur J Pain. 2001;5(4):405-13. doi: 10.1053/eujp.2001.0261.
Coping is a cyclical process in which an individual evaluates stressful events, chooses and implements coping strategies, re-evaluates the outcome of the coping effort and modifies the strategy if necessary. The intent of the present study was to evaluate the extent to which pain-related adjustment (i.e. pain severity, pain interference, negative affect) and perceptions of control are associated with the implementation of particular coping strategies. Participants were 136 patients assessed at an interdisciplinary pain clinic for cervical sprain injuries. As part of a routine assessment, participants completed a questionnaire package regarding background, pain severity, pain interference, negative affect, perceived control and use of particular coping strategies. Results of hierarchical multiple regression analyses revealed that pain interference, after controlling for all other variables, was associated with greater use of less physically demanding strategies (i.e. resting, guarding, asking for assistance, seeking social support and coping self-statements). Negative affect, on the other hand, after controlling for other variables, was associated with reduced use of task persistence. Finally, perceived control, independent of other variables, was associated with greater use of cognitive and social coping strategies (i.e. asking for assistance, seeking social support and coping self-statements). The results of the study shed light on the complex relationship between use of particular coping strategies and situational variables of pain-related adjustment and perceived control. Implications for clinicians who assist patients via implementation or modification of particular coping techniques are discussed.
应对是一个循环过程，在此过程中，个体评估应激事件，选择并实施应对策略，重新评估应对努力的结果，并在必要时修改策略。本研究的目的是评估与疼痛相关的调整（即疼痛严重程度、疼痛干扰、消极情绪）和控制感在多大程度上与特定应对策略的实施相关。研究对象为136名在一家跨学科疼痛诊所接受颈椎扭伤评估的患者。作为常规评估的一部分，参与者完成了一份关于背景、疼痛严重程度、疼痛干扰、消极情绪、感知控制和特定应对策略使用情况的问卷包。分层多元回归分析结果显示，在控制了所有其他变量后，疼痛干扰与更多地使用体力要求较低的策略（即休息、保护、寻求帮助、寻求社会支持和应对自我陈述）相关。另一方面，在控制了其他变量后，消极情绪与减少任务坚持性的使用相关。最后，独立于其他变量的感知控制与更多地使用认知和社会应对策略（即寻求帮助、寻求社会支持和应对自我陈述）相关。该研究结果揭示了特定应对策略的使用与疼痛相关调整和感知控制的情境变量之间的复杂关系。文中还讨论了对通过实施或修改特定应对技巧来帮助患者的临床医生的启示。
