慢性肌肉骨骼疼痛女性心理困扰与幸福感的预测因素:同一硬币的两面?
Predictors of psychological distress and well-being in women with chronic musculoskeletal pain: two sides of the same coin?
作者信息
Huber Alexa, Suman Anna Lisa, Biasi Giovanni, Carli Giancarlo
机构信息
Department of Physiology, Siena University, Siena, Italy.
出版信息
J Psychosom Res. 2008 Feb;64(2):169-75. doi: 10.1016/j.jpsychores.2007.09.005.
OBJECTIVE
To date, few results on well-being in chronic-pain patients have been published, while several studies in patients without pain have indicated that well-being may not be equivalent to absence of psychological distress. The aim of the present study was to investigate the relationship between psychological distress and well-being and to identify the predictors of each in patients with chronic nonmalignant pain.
METHODS
Sixty-nine women with chronic multiregional musculoskeletal pain, 41 of whom met American College of Rheumatology criteria for fibromyalgia, completed questionnaires on pain, fatigue, stiffness, physical disability (Fibromyalgia Impact Questionnaire), psychological distress [Multidimensional Affect and Pain Survey (MAPS), Symptom Check List-90 (SCL-90), State-Trait Anxiety Inventory Form Y2 (STAI-Y2)], and hedonic and eudaimonic well-being (MAPS).
RESULTS
Patients reported increased amounts of psychological distress (STAI-Y2 and SCL-90) compared to healthy people. Multiple regression analysis of patient data demonstrated that higher psychological distress was related to higher age, more intense pain, a higher positive tender point count, and more physical disability. Well-being (both hedonic and eudaimonic aspects) decreased with higher disability, but was independent of age, pain intensity, and number of positive tender points. Bivariate correlations showed that psychological distress was moderately related to eudaimonic well-being and strongly related to positive affect, an aspect of hedonic well-being.
CONCLUSION
In patients with chronic musculoskeletal pain, self-reports of well-being and low psychological distress only partially overlap with each other and are differently related to major patient symptoms, supporting the relevance of the concept of well-being to chronic-pain research and a need for further studies in this field.
目的
迄今为止,关于慢性疼痛患者幸福感的研究结果鲜有发表,而多项针对无疼痛患者的研究表明,幸福感可能并不等同于没有心理困扰。本研究的目的是调查慢性非恶性疼痛患者心理困扰与幸福感之间的关系,并确定二者各自的预测因素。
方法
69名患有慢性多部位肌肉骨骼疼痛的女性完成了关于疼痛、疲劳、僵硬、身体残疾(纤维肌痛影响问卷)、心理困扰[多维情感与疼痛调查(MAPS)、症状自评量表90(SCL - 90)、状态 - 特质焦虑量表Y2版(STAI - Y2)]以及享乐主义和自我实现幸福感(MAPS)的问卷调查,其中41名符合美国风湿病学会纤维肌痛标准。
结果
与健康人相比,患者报告的心理困扰(STAI - Y2和SCL - 90)更多。对患者数据进行的多元回归分析表明,较高的心理困扰与较高年龄、更强烈的疼痛、更高的阳性压痛点计数以及更多的身体残疾有关。幸福感(包括享乐主义和自我实现两个方面)随着残疾程度的增加而降低,但与年龄、疼痛强度和阳性压痛点数量无关。双变量相关性分析表明,心理困扰与自我实现幸福感中度相关,与享乐主义幸福感的一个方面即积极情感强烈相关。
结论
在慢性肌肉骨骼疼痛患者中,幸福感的自我报告和低心理困扰仅部分重叠,且与主要患者症状的关联不同,这支持了幸福感概念在慢性疼痛研究中的相关性以及该领域进一步研究的必要性。