Université de Sherbrooke, Longueuil, Québec, Canada University of Trento, Trento, Italy Simon Fraser University, Burnaby, British Columbia, Canada University of British Columbia, Vancouver, British Columbia, Canada Fraser Health Authority, Workplace Health Program, Surrey, British Columbia, Canada.
Pain. 2011 Nov;152(11):2543-2548. doi: 10.1016/j.pain.2011.07.024. Epub 2011 Aug 21.
Studies in the literature do not show clear evidence supporting the relationship between pain and depressive symptoms in individuals experiencing acute/subacute pain compared to those experiencing chronic pain. However, more information is needed about which variables act as mediators in the pain-depression relationship in people having acute/subacute pain, before pain becomes chronic. Our objectives were to test the suitability of the fear-avoidance model in a sample of 110 health care workers experiencing acute/subacute pain using path analyses, to improve the model as needed, and to examine a model involving both pain catastrophizing and pain self-efficacy with work status as a final outcome. Overall, the results indicated that adjustments to the fear-avoidance model were required for people experiencing acute/subacute pain, in which fear-avoidance beliefs and depressive symptoms were concurrent rather than sequential. The catastrophizing concept was most closely associated with depressive symptoms, while pain self-efficacy was directly associated with fear-avoidance beliefs and indirectly to work outcomes. Assessing and modifying pain self-efficacy in acute/subacute pain patients is important for interventions aiming to decrease fear-avoidance and improve work outcomes.
文献研究并未提供明确证据支持经历急性/亚急性疼痛的个体与经历慢性疼痛的个体之间疼痛与抑郁症状之间的关系。然而，在疼痛变为慢性之前，需要更多关于哪些变量在经历急性/亚急性疼痛的人群中充当疼痛-抑郁关系的中介因素的信息。我们的目的是使用路径分析在 110 名经历急性/亚急性疼痛的医护人员样本中测试恐惧回避模型的适用性，根据需要改进模型，并检查一个涉及疼痛灾难化和疼痛自我效能的模型，以工作状况作为最终结果。总体而言，结果表明，经历急性/亚急性疼痛的人需要对恐惧回避模型进行调整，其中恐惧回避信念和抑郁症状是同时发生的，而不是先后发生的。灾难化概念与抑郁症状最密切相关，而疼痛自我效能与恐惧回避信念直接相关，并间接地与工作结果相关。评估和改变急性/亚急性疼痛患者的疼痛自我效能对于旨在减少恐惧回避和改善工作结果的干预措施非常重要。
