Newton-John Toby R O, Mason Christie, Hunter Mick
School of Psychology.
Faculty of Science and Information Technology, University of Newcastle.
Rehabil Psychol. 2014 Aug;59(3):360-5. doi: 10.1037/a0037023. Epub 2014 Jul 14.
In clinical practice, it is often noted that some individuals struggle with chronic pain, while others find effective means to cope. The purpose of this study was to better understand how resilience fits into coping with persistent pain problems. Of interest was whether measures of resilience add to the prediction of adjustment to chronic pain over and above measures of pain coping as typically used with this patient group.
Individuals (N = 101) with chronic pain who attended an initial assessment at a pain clinic completed self-report measures of resilience and coping. Pain related outcome data were also collected.
Bivariate correlations indicated that higher resilience was associated with significantly less fear avoidance, less pain-related disability, and lower reported pain intensity. Consistent with theoretical propositions, bivariate analyses also indicated that more resilient individuals with chronic pain reported better social support, and were more likely to be working. Higher resilience was also positively correlated with greater pain self-efficacy. However, when hierarchical regression analyses were performed, resilience did not add significantly to the prediction of depression scores and disability scores, over and above the contribution made by existing measures of pain coping.
These findings suggest that, although the construct of resilience appears to have important relationships with various dimensions of chronic pain, as currently operationalized, it does not add significantly to the understanding of chronic-pain adjustment. Rather than abandoning the resilience construct, our findings suggest that resilience as applied to the problem of chronic pain may require a refinement in measurement with this population.
在临床实践中，经常会注意到一些人在慢性疼痛中挣扎，而另一些人则找到了有效的应对方法。本研究的目的是更好地理解心理韧性如何与应对持续性疼痛问题相契合。我们感兴趣的是，除了通常用于该患者群体的疼痛应对措施之外，心理韧性指标是否能增强对慢性疼痛适应情况的预测。
在疼痛诊所参加初始评估的101名慢性疼痛患者完成了心理韧性和应对的自我报告测量。还收集了与疼痛相关的结果数据。
双变量相关性分析表明，心理韧性越高，恐惧回避行为越少、与疼痛相关的残疾程度越低、报告的疼痛强度越低。与理论命题一致，双变量分析还表明，心理韧性更强的慢性疼痛患者报告的社会支持更好，并且更有可能在工作。更高的心理韧性也与更高的疼痛自我效能感呈正相关。然而，在进行分层回归分析时，除了现有的疼痛应对措施所做的贡献之外，心理韧性并没有显著增强对抑郁得分和残疾得分的预测。
这些发现表明，虽然心理韧性这一概念似乎与慢性疼痛的各个维度有着重要关系，但就目前的操作而言，它并没有显著增进我们对慢性疼痛适应情况的理解。我们的研究结果并非建议摒弃心理韧性这一概念，而是表明应用于慢性疼痛问题的心理韧性可能需要针对该人群在测量方法上进行改进。
