Cano Annmarie, Johansen Ayna B, Franz Aleda
Department of Psychology, Wayne State University, 5057 Woodward Avenue, Detroit, MI 48202, USA.
Pain. 2005 Dec 5;118(3):369-379. doi: 10.1016/j.pain.2005.09.003. Epub 2005 Nov 14.
Couple congruence on ratings of pain severity and disability were examined using hierarchical linear modeling. Older community Individuals with Chronic Pain (ICPs) and their spouses completed the Multidimensional Pain Inventory (pain severity, interference, negative spouse responses to pain), Sickness Impact Profile (physical disability, psychosocial disability), and the Mood and Anxiety Symptom Questionnaire (psychological distress). Both spouses reported on ICPs' pain and disability as well as their own psychological distress. Spousal incongruence was observed on interference and physical disability such that ICPs reported greater disability than their spouses reported for them. No significant incongruence was observed in pain severity or psychosocial disability. Predictors of couples' mean ratings of pain and disability were identified. Specifically, couples in which the ICP was female reported higher couples' ratings of pain severity and interference. ICP distress was related to higher couples' ratings of all pain and disability variables whereas spouse distress was related to higher psychosocial disability ratings. ICPs' perceptions of negative spouse responses were also positively associated with couples' ratings of physical and psychosocial disability. In terms of congruence, ICP distress was associated with incongruence on interference, physical disability, and psychosocial disability whereas spouse distress predicted incongruence on pain severity, and interference. This study suggests that understanding couples' pain outcome ratings involves an awareness of factors that might influence their perceptions and behaviors.
采用分层线性模型研究了夫妻在疼痛严重程度和残疾评定方面的一致性。患有慢性疼痛（ICP）的老年社区个体及其配偶完成了多维疼痛量表（疼痛严重程度、干扰、配偶对疼痛的负面反应）、疾病影响量表（身体残疾、心理社会残疾）以及情绪和焦虑症状问卷（心理困扰）。夫妻双方都报告了ICP的疼痛和残疾情况以及他们自己的心理困扰。在干扰和身体残疾方面观察到配偶间的不一致，即ICP报告的残疾程度高于其配偶为他们报告的程度。在疼痛严重程度或心理社会残疾方面未观察到显著的不一致。确定了夫妻疼痛和残疾平均评定的预测因素。具体而言，ICP为女性的夫妻报告的疼痛严重程度和干扰程度较高。ICP的困扰与夫妻对所有疼痛和残疾变量的较高评定相关，而配偶的困扰与较高的心理社会残疾评定相关。ICP对配偶负面反应的认知也与夫妻对身体和心理社会残疾的评定呈正相关。在一致性方面，ICP的困扰与干扰、身体残疾和心理社会残疾方面的不一致相关，而配偶的困扰则预测了疼痛严重程度和干扰方面的不一致。这项研究表明，理解夫妻的疼痛结果评定需要意识到可能影响他们认知和行为的因素。
