Riley J L, Myers C D, Robinson M E, Bulcourf B, Gremillion H A
Division of Public Health Service and Research, College of Dentistry, Department of Clinical and Health Psychology, College of Health Professions, P. O. Box 100404 HSC, University of Florida, Gainesville, FL 32610-0404, USA.
J Orofac Pain. 2001 Winter;15(1):29-35.
To determine psychosocial predictors of patients' ratings of satisfaction with improvement and subjective pain relief. This study also examined the underlying components of patient satisfaction with improvement, as assessed at follow-up.
The sample consisted of 107 chronic orofacial pain patients evaluated at a university-based orofacial pain clinic and referred for treatment with individualized treatment plans. Pain and psychosocial functioning were assessed with standard, reliable, validated self-report instruments administered at the initial evaluation. Follow-up data were collected via a telephone-administered structured interview 8 months after the initial evaluation. Regression methodology was used to determine prediction models for satisfaction with improvement and subjective pain relief. Patient ratings of the quality of the caregiver communication were used as a control variable in all analyses.
Quality of caregiver communication predicted approximately 10 to 14% of the variance in outcomes in all models. Greater initial use of cognitive coping strategies and reduced depression predicted higher ratings of satisfaction with improvement and increased pain relief. When concurrent relationships among variables at the follow-up were examined, greater subjective pain relief since the evaluation, lower current pain, and higher ratings of overall mood were significant predictors of patient satisfaction with improvement.
This study is one of the first to report that the use of certain cognitive coping strategies is associated with positive outcome for patients suffering from orofacial pain. These findings underscore the importance of individual differences on behavioral and psychosocial parameters in the prediction of patients' subjective evaluation of treatment outcome.
确定患者对病情改善和主观疼痛缓解满意度评分的社会心理预测因素。本研究还对随访时评估的患者病情改善满意度的潜在组成部分进行了考察。
样本包括107名慢性口面部疼痛患者,这些患者在一家大学口腔面部疼痛诊所接受评估,并根据个性化治疗方案接受治疗。在初次评估时使用标准、可靠且经过验证的自我报告工具对疼痛和社会心理功能进行评估。随访数据通过初次评估8个月后电话进行的结构化访谈收集。采用回归方法确定病情改善满意度和主观疼痛缓解的预测模型。在所有分析中,将患者对护理人员沟通质量的评分用作控制变量。
在所有模型中,护理人员沟通质量预测了约10%至14%的结果差异。更多地初始使用认知应对策略和减轻抑郁可预测更高的病情改善满意度评分和更高的疼痛缓解程度。在考察随访时变量之间的并发关系时,自评估以来更大程度的主观疼痛缓解、更低的当前疼痛以及更高的总体情绪评分是患者病情改善满意度的显著预测因素。
本研究是首批报告使用某些认知应对策略与口面部疼痛患者的积极结果相关的研究之一。这些发现强调了个体差异在行为和社会心理参数方面对预测患者治疗结果主观评估的重要性。