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特发性慢性颈痛患者认知因素、疼痛与残疾的相关性。

The association between cognitive factors, pain and disability in patients with idiopathic chronic neck pain.

机构信息

The Pennine Acute Hospitals NHS Trust, Department of Physiotherapy, North Manchester General Hospital, Crumpsall, Manchester, United Kingdom.

出版信息

Disabil Rehabil. 2010;32(21):1758-67. doi: 10.3109/09638281003734342.

Abstract

PURPOSE

The aim of this study was to establish the relationship between known cognitive factors and levels of pain and disability in patients with idiopathic chronic neck pain.

METHOD

Ninety-four patients referred for physiotherapy because of chronic neck pain completed measures of pain, disability, catastrophising, pain-related fear, pain vigilance and awareness and self-efficacy beliefs. Hierarchical multiple regression analyses were then performed to establish whether the cognitive factors were significant determinants of levels of pain and disability.

RESULTS

The cognitive measures were significantly related to levels of pain and disability, explaining 23% of the variance in pain intensity and 30% of the variance in disability. Specifically, greater catastrophising (beta  =  0.37, p  <  0.05) and lower pain vigilance and awareness (beta =  -  0.32, p  <  0.05) were associated with greater pain intensity. Moreover, greater catastrophising (beta =  0.26, p  <  0.05) and lower functional self-efficacy beliefs (beta =  -  0.34, p  <  0.001) were significantly associated with greater levels of disability.

CONCLUSIONS

Cognitive factors were strongly related to levels of pain and disability in patients with chronic neck pain. In view of this, targeting the modification of these cognitive factors should be an integral part of therapy when treating patients with idiopathic chronic neck pain.

摘要

目的

本研究旨在确定特发性慢性颈痛患者的已知认知因素与疼痛和残疾程度之间的关系。

方法

94 名因慢性颈痛而接受物理治疗的患者完成了疼痛、残疾、灾难化、与疼痛相关的恐惧、疼痛警觉和意识以及自我效能信念的测量。然后进行了层次多重回归分析,以确定认知因素是否是疼痛和残疾程度的重要决定因素。

结果

认知测量与疼痛和残疾程度显著相关,解释了疼痛强度变异的 23%和残疾程度变异的 30%。具体而言,更大的灾难化(β=0.37,p<0.05)和更低的疼痛警觉和意识(β=-0.32,p<0.05)与更大的疼痛强度相关。此外,更大的灾难化(β=0.26,p<0.05)和更低的功能自我效能信念(β=-0.34,p<0.001)与更大的残疾程度显著相关。

结论

认知因素与慢性颈痛患者的疼痛和残疾程度密切相关。鉴于此,当治疗特发性慢性颈痛患者时,针对这些认知因素的修正应该是治疗的一个组成部分。

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