Porcelli Piero, Tulipani Cinzia, Maiello Evaristo, Cilenti Giuseppina, Todarello Orlando
Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Bari, Italy.
Psychooncology. 2007 Jul;16(7):644-50. doi: 10.1002/pon.1115.
This paper aimed to investigate the role played by key psychological factors in the experience of pain in cancer. One hundred and eight consecutive cancer patients were administered validated scales for pain, alexithymia, coping with cancer, and illness behavior. Two groups of patients with (n=45, 42%) and without (n=63, 58%) current pain were compared. Pain was associated to tumor sites and status, poor adjustment to cancer, and higher disease conviction and perception, but not to global alexithymia. However, the component of difficulty identifying feelings (DIF) of the alexithymia construct was significantly higher in pain patients compared to pain-free patients (t=2.88, p<0.01), constituted one of the independent predictors of pain (r=0.37; beta=0.27, p<0.01), and correlated with quality descriptors of pain (r=0.33, p<0.05). The present findings showed for the first time that although alexithymia was not globally related to cancer pain, the DIF component was however associated to pain dimensions, thus suggesting it might be involved in the way patients describe their pain experience, together with maladaptive coping and abnormal illness behavior. Cancer patients experiencing pain should be helped to adopt a more adaptive coping with the disease by identifying more accurately the source of their feelings.
本文旨在探究关键心理因素在癌症疼痛体验中所起的作用。对108例连续就诊的癌症患者进行了疼痛、述情障碍、应对癌症及患病行为的有效量表测评。比较了两组患者，一组为当前有疼痛的患者（n = 45，42%），另一组为当前无疼痛的患者（n = 63，58%）。疼痛与肿瘤部位和状态、对癌症的适应不良、更高的疾病确信度和感知相关，但与整体述情障碍无关。然而，与无疼痛患者相比，疼痛患者的述情障碍结构中情感识别困难（DIF）成分显著更高（t = 2.88，p < 0.01），构成疼痛的独立预测因素之一（r = 0.37；β = 0.27，p < 0.01），并与疼痛的质量描述相关（r = 0.33，p < 0.05）。本研究结果首次表明，虽然述情障碍与癌症疼痛并无整体关联，但DIF成分却与疼痛维度相关，因此表明它可能与适应不良应对及异常患病行为一起，参与了患者描述其疼痛体验的方式。应帮助经历疼痛的癌症患者通过更准确地识别其情感来源，采用更具适应性的方式应对疾病。
