Ramírez-Maestre Carmen, Esteve Rosa, López Alicia E
Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Faculty of Psychology, Universidad de Málaga, Campus de Teatinos, 29071 Málaga, Spain.
Eur J Pain. 2008 Aug;12(6):749-56. doi: 10.1016/j.ejpain.2007.11.004. Epub 2007 Dec 21.
This study analyses the relationships between patients' cognitive appraisals concerning their pain and the coping strategies they use. In addition, the way the coping strategy influences the intensity of perceived pain and impairment in these patients was studied.
One hundred and twenty two patients with musculoskeletal chronic pain participated. The assessment tools were as follows: The Cognitive Appraisal Inventory for Chronic Pain Patients (CAI), the Vanderbilt Pain Management Inventory (VPMI), the McGill Pain Questionnaire (MPQ) and the Impairment and Functioning Inventory for Chronic Pain Patients (IFI). The hypothetical model was empirically tested using the LISREL 8.20 software package and the unweighted least squares method.
High levels of challenge appraisal were associated with low levels of passive coping and high levels of active coping strategies, whereas the harm, loss or threat appraisal predicted high use of passive coping strategies. Passive coping had three statistically significant path coefficients: high levels of passive coping were associated with low levels of functioning and high levels of pain intensity and impairment. However, high levels of active coping reported high levels of daily functioning.
By analysing the cognitive appraisals made by chronic pain patients, clinicians could make better predictions regarding the way they cope and adjust.
本研究分析了患者对自身疼痛的认知评估与他们所采用的应对策略之间的关系。此外，还研究了应对策略对这些患者感知疼痛强度和功能损害的影响方式。
122名患有肌肉骨骼慢性疼痛的患者参与了研究。评估工具如下：慢性疼痛患者认知评估量表（CAI）、范德比尔特疼痛管理量表（VPMI）、麦吉尔疼痛问卷（MPQ）以及慢性疼痛患者功能损害量表（IFI）。使用LISREL 8.20软件包和非加权最小二乘法对假设模型进行了实证检验。
高水平的挑战评估与低水平的消极应对和高水平的积极应对策略相关，而伤害、损失或威胁评估则预示着消极应对策略的高使用率。消极应对有三个具有统计学意义的路径系数：高水平的消极应对与低水平的功能以及高水平的疼痛强度和功能损害相关。然而，高水平的积极应对表明日常功能水平较高。
通过分析慢性疼痛患者的认知评估，临床医生可以更好地预测他们的应对方式和调整情况。
