Molton Ivan R, Jensen Mark P, Nielson Warren, Cardenas Diana, Ehde Dawn M
Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington 98195,
J Pain. 2008 Jul;9(7):606-12. doi: 10.1016/j.jpain.2008.01.338. Epub 2008 Mar 24.
Chronic pain commonly accompanies long-term disabilities such as spinal cord injury (SCI). Research suggests that patient motivation to engage in adaptive pain coping strategies, such as exercise/stretching and task persistence, is an important factor in determining the impact that this pain will have on quality of life. One recently proposed model (the Motivational Model of Pain Self-Management) suggests that motivation to manage pain is influenced by 2 primary variables: Beliefs about the importance of engaging in pain self-management (ie, perceived importance) and beliefs about one's own ability to engage in these behaviors (ie, self-efficacy). The purpose of this study was to provide a preliminary test of this model in a sample of 130 adults with SCI who completed a return by mail survey. Measures included a numerical rating scale of pain intensity and the revised version of the Multidimensional Pain Readiness to Change Questionnaire. Mediation analyses were performed using multiple regression. Results suggested that the effects of perceived importance and self-efficacy on exercise behavior were mediated by readiness to engage in exercise, consistent with the proposed model. However, the model could not be established for the outcome of task persistence.
This study tests a model describing motivation to engage in pain management behaviors (ie, "readiness to change") in adults with SCI. This model could potentially aid clinicians in their conceptualization of the factors that affect patient motivation to manage pain.
慢性疼痛常伴随脊髓损伤（SCI）等长期残疾。研究表明，患者参与适应性疼痛应对策略（如运动/伸展和任务坚持）的动机是决定这种疼痛对生活质量影响的重要因素。最近提出的一个模型（疼痛自我管理动机模型）表明，管理疼痛的动机受两个主要变量影响：对参与疼痛自我管理重要性的信念（即感知重要性）和对自己参与这些行为能力的信念（即自我效能感）。本研究的目的是在130名成年脊髓损伤患者样本中对该模型进行初步测试，这些患者通过邮寄方式完成了一项调查。测量指标包括疼痛强度数字评分量表和多维疼痛改变准备情况问卷修订版。使用多元回归进行中介分析。结果表明，感知重要性和自我效能感对运动行为的影响通过参与运动的准备情况介导，这与所提出的模型一致。然而，对于任务坚持这一结果，该模型无法建立。
本研究测试了一个描述脊髓损伤成年患者参与疼痛管理行为动机（即“改变准备情况”）的模型。该模型可能有助于临床医生理解影响患者管理疼痛动机的因素。
