Wollaars Marieke M, Post Marcel W M, van Asbeck Floris W A, Brand Nico
Rehabilitation Centre De Hoogstraat, Rembrandtkade 10, 3583 TM Utrecht, The Netherlands.
Clin J Pain. 2007 Jun;23(5):383-91. doi: 10.1097/AJP.0b013e31804463e5.
To examine chronic pain prevalence in a spinal cord injury (SCI) population, and to determine the influence of psychologic factors on SCI pain and impact of SCI pain on quality of life.
Five hundred seventy-five persons with SCI were asked to participate in the study. Demographic, SCI, and pain characteristics were obtained. The Chronic Pain Grade, anger items of the Profile of Mood States, Illness Cognition Questionnaire, Pain Coping and Cognition List, and Patient Health Questionnaire were used. General health and well-being were assessed with 0-10 scales. The influence of psychologic factors was assessed with regression analyses controlling for person and injury characteristics and pain intensity.
Response rate was 49%. SCI pain prevalence was high (77.1%). More internal pain control and coping, less catastrophizing, higher level of lesion, and nontraumatic SCI cause were associated with less pain intensity. More pain was associated with higher pain-related disability. Lower catastrophizing was related to better health. Less SCI helplessness and catastrophizing, greater SCI acceptance and lower anger levels were related to higher well-being. Higher levels of SCI helplessness, catastrophizing, and anger were related to higher depression levels. Pain intensity showed no independent relationships with health, well-being, and depression in the regression analyses.
Chronic SCI pain and quality of life were both largely associated with several psychologic factors of which pain catastrophizing and SCI helplessness were most important. Psychologic intervention programs may be useful for persons suffering from chronic SCI pain to improve their quality of life.
研究脊髓损伤（SCI）人群中慢性疼痛的患病率，确定心理因素对SCI疼痛的影响以及SCI疼痛对生活质量的影响。
邀请575名SCI患者参与研究。获取人口统计学、SCI及疼痛特征信息。使用慢性疼痛分级、情绪状态剖面图中的愤怒项目、疾病认知问卷、疼痛应对与认知清单以及患者健康问卷。采用0至10分制评估总体健康和幸福感。通过控制个体和损伤特征以及疼痛强度的回归分析评估心理因素的影响。
回复率为49%。SCI疼痛患病率较高（77.1%）。更多的内在疼痛控制和应对、更少的灾难化思维、更高的损伤水平以及非创伤性SCI病因与更低的疼痛强度相关。更多疼痛与更高的疼痛相关残疾有关。更低的灾难化思维与更好的健康状况相关。更少的SCI无助感和灾难化思维、更高的SCI接受度以及更低的愤怒水平与更高的幸福感相关。更高水平的SCI无助感、灾难化思维和愤怒与更高的抑郁水平相关。在回归分析中，疼痛强度与健康、幸福感和抑郁无独立关联。
慢性SCI疼痛和生活质量在很大程度上都与多种心理因素相关，其中疼痛灾难化思维和SCI无助感最为重要。心理干预项目可能有助于患有慢性SCI疼痛的患者提高生活质量。
