Noro Mifumi, Oka Koichiro, Shibata Ai, Nakamura Yoshio
Tokyu Sports Oasis, Co. Ltd.
Nihon Ronen Igakkai Zasshi. 2008 Sep;45(5):539-45. doi: 10.3143/geriatrics.45.539.
The present study examined the association of pain coping strategy with pain and activity restriction among middle-aged and elderly women with the knee pain.
The participants were 134 female community residents (62.1+/-8.2 years) with knee pain. The pain and activity restriction were assessed with the Japanese Knee Osteoarthritis Measure (JKOM). The pain coping strategy was evaluated using the Japanese short version of the Coping Strategy Questionnaire (CSQ). A theoretical model was developed to explain the relationships among age, pain, activity restriction, and pain coping strategy. This model was then tested using structural equation modeling (SEM).
The overall fit index was adequate for the final model (GFI=.980, AGFI=.946, CFI=.995, RMSEA=.022). SEM indicated that increasing age had a significant association with increasing pain, and indirect influence on progressive activity restriction. Also, aggravating pain was significantly associated with adopting more "praying or hoping", "catastrophizing", and "increasing pain behavior" as pain coping strategy, and indirectly affected progress in activity restriction.
The results indicate that reducing the use of maladaptive coping strategy would be important to promote the ability of pain self-management among middle-aged and elderly women with knee pain. The present study suggests that it would be necessary to incorporate the cognitive-behavioral approaches in order to modify the use of maladaptive coping strategy in existing therapeutic exercise intervention for knee pain.
本研究探讨了膝关节疼痛的中老年女性的疼痛应对策略与疼痛及活动受限之间的关联。
参与者为134名有膝关节疼痛的女性社区居民(年龄62.1±8.2岁)。采用日本膝关节骨关节炎测量表(JKOM)评估疼痛和活动受限情况。使用日本简短版应对策略问卷(CSQ)评估疼痛应对策略。构建了一个理论模型来解释年龄、疼痛、活动受限和疼痛应对策略之间的关系。然后使用结构方程模型(SEM)对该模型进行检验。
最终模型的整体拟合指数良好(GFI = 0.980,AGFI = 0.946,CFI = 0.995,RMSEA = 0.022)。结构方程模型表明,年龄增长与疼痛加剧显著相关,并对活动受限的进展有间接影响。此外,疼痛加剧与采用更多“祈祷或期望”“灾难化”和“增加疼痛行为”作为疼痛应对策略显著相关,并间接影响活动受限的进展。
结果表明,减少适应不良应对策略的使用对于提高膝关节疼痛的中老年女性的疼痛自我管理能力至关重要。本研究表明,有必要在现有的膝关节疼痛治疗性运动干预中纳入认知行为方法,以改变适应不良应对策略的使用。