Murphy Susan L, Kratz Anna L, Williams David A, Geisser Michael E
Department of Physical Medicine and Rehabilitation, University of Michigan Ann Arbor, MI, USA.
Front Psychol. 2012 Sep 3;3:326. doi: 10.3389/fpsyg.2012.00326. eCollection 2012.
Effective use of coping strategies by people with chronic pain conditions is associated with better functioning and adjustment to chronic disease. Although the effects of coping on pain have been well studied, less is known about how specific coping strategies relate to actual physical activity patterns in daily life. The purpose of this study was to evaluate how different coping strategies relate to symptoms and physical activity patterns in a sample of adults with knee and hip osteoarthritis (OA; N = 44). Physical activity was assessed by wrist-worn accelerometry; coping strategy use was assessed by the Chronic Pain Coping Inventory. We hypothesized that the use of coping strategies that reflect approach behaviors (e.g., Task Persistence), would be associated with higher average levels of physical activity, whereas avoidance coping behaviors (e.g., Resting, Asking for Assistance, Guarding) and Pacing would be associated with lower average levels of physical activity. We also evaluated whether coping strategies moderated the association between momentary symptoms (pain and fatigue) and activity. We hypothesized that higher levels of approach coping would be associated with a weaker association between symptoms and activity compared to lower levels of this type of coping. Multilevel modeling was used to analyze the momentary association between coping and physical activity. We found that higher body mass index, fatigue, and the use of Guarding were significantly related to lower activity levels, whereas Asking for Assistance was significantly related to higher activity levels. Only Resting moderated the association between pain and activity. Guarding, Resting, Task Persistence, and Pacing moderated the association between fatigue and activity. This study provides an initial understanding of how people with OA cope with symptoms as they engage in daily life activities using ecological momentary assessment and objective physical activity measurement.
慢性疼痛患者有效运用应对策略与更好地应对慢性病及功能改善相关。尽管应对方式对疼痛的影响已得到充分研究，但对于特定应对策略与日常生活中实际身体活动模式之间的关系却知之甚少。本研究旨在评估不同应对策略与膝骨关节炎和髋骨关节炎成年患者（样本量N = 44）的症状及身体活动模式之间的关系。通过佩戴在手腕上的加速度计评估身体活动；通过慢性疼痛应对量表评估应对策略的使用情况。我们假设，采用反映积极应对行为的应对策略（如任务坚持性）与较高的平均身体活动水平相关，而回避应对行为（如休息、寻求帮助、保护）及节奏控制则与较低的平均身体活动水平相关。我们还评估了应对策略是否调节了瞬时症状（疼痛和疲劳）与活动之间的关联。我们假设，与较低水平的此类应对方式相比，较高水平的积极应对方式与症状和活动之间的关联较弱。采用多水平模型分析应对方式与身体活动之间的瞬时关联。我们发现，较高的体重指数、疲劳以及采用保护策略与较低的活动水平显著相关，而寻求帮助则与较高的活动水平显著相关。只有休息调节了疼痛与活动之间的关联。保护、休息、任务坚持性和节奏控制调节了疲劳与活动之间的关联。本研究通过生态瞬时评估和客观的身体活动测量，初步了解了骨关节炎患者在参与日常生活活动时如何应对症状。
