Nicholson Perry Kathryn, Nicholas Michael K, Middleton James
The University of Sydney Pain Management and Research Centre, Royal North Shore Hospital, Sydney, Australia.
Eur J Pain. 2009 May;13(5):511-7. doi: 10.1016/j.ejpain.2008.06.003. Epub 2008 Jul 23.
Although psychological aspects of SCI-related pain have been investigated in those with chronic pain, little data is available regarding these factors in those early in the course of the injury. Using a sample admitted for SCI rehabilitation, this paper describes the relationships between usual pain intensity, mood, disability and both pain and SCI-related psychological factors. The sample were largely similar to other samples of individuals with SCI-related chronic pain in terms of mood, but were noted to be less catastrophic in their thinking about pain than a comparative pain clinic sample. They also reported SCI self-efficacy and acceptance scores consistent with other SCI samples. Compared with other SCI populations there were mixed findings in relation to physical disability. Consistent with previous findings in chronic pain SCI samples, usual pain intensity was found to have a strong relationship with symptoms of anxiety and depression, and pain-related life interference. SCI acceptance was significantly negatively associated with depression scores, pain catastrophizing was significantly positively associated with both anxiety and depression scores, and SCI self-efficacy was significantly negatively associated with both anxiety and depression scores. SCI self-efficacy was also significantly positively associated with physical function scores. These findings suggest that pain-related psychological factors may have importance even early in the clinical course following SCI, but that it is important, however, to consider more general SCI-related psychological factors alongside them. In addition, these findings suggest the possibility that early interventions based upon the cognitive behavioural treatment of pain may be integrated into SCI rehabilitation programmes.
尽管已经对慢性疼痛患者脊髓损伤相关疼痛的心理方面进行了研究，但关于损伤早期患者的这些因素的数据却很少。本文以一个因脊髓损伤康复入院的样本为例，描述了日常疼痛强度、情绪、残疾与疼痛及脊髓损伤相关心理因素之间的关系。该样本在情绪方面与其他脊髓损伤相关慢性疼痛患者的样本大致相似，但在对疼痛的认知方面，与一个对比性疼痛诊所样本相比，其灾难性思维较少。他们报告的脊髓损伤自我效能感和接纳度得分与其他脊髓损伤样本一致。与其他脊髓损伤人群相比，在身体残疾方面的研究结果喜忧参半。与慢性疼痛脊髓损伤样本之前的研究结果一致，日常疼痛强度与焦虑和抑郁症状以及与疼痛相关的生活干扰密切相关。脊髓损伤接纳度与抑郁得分显著负相关，疼痛灾难化与焦虑和抑郁得分均显著正相关，脊髓损伤自我效能感与焦虑和抑郁得分均显著负相关。脊髓损伤自我效能感与身体功能得分也显著正相关。这些发现表明，即使在脊髓损伤后的临床过程早期，与疼痛相关的心理因素可能也很重要，但与此同时，考虑更一般的脊髓损伤相关心理因素也很重要。此外，这些发现表明，基于疼痛认知行为治疗的早期干预有可能被纳入脊髓损伤康复计划。
