Wong Harry J, Anitescu Magdalena
Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, U.S.A.
Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, Illinois, U.S.A.
Pain Pract. 2017 Jan;17(1):52-61. doi: 10.1111/papr.12410. Epub 2016 Feb 20.
Chronic pain is significantly influenced by behavioral, cognitive, and emotional factors. Few studies have investigated the health locus of control (HLC)-one's belief regarding where control over one's health lies-as it relates to patients with chronic pain. The purpose of this prospective, cross-sectional study was to examine the relationship between depression and health/pain locus of control (HLC) in adult patients with persistent pain.
A series of questionnaires was administered to chronic pain patients, and these questionnaires were scored and analyzed. Patients were categorized into 3 groups based on health locus of control (internal, chance, powerful-others), which were examined with respect to their depression scores using analysis of variance.
A total of 131 patients completed the study: 33% belonged to the internal group, 39% in the chance group, and 28% in the powerful-others group. The 3 groups had depression scores of 40 (SD = 8), 47 (SD = 10), and 42 (SD = 8), respectively. We found significant difference in depressions scores between the chance group and the internal group (P < 0.005) with the chance group having higher depression scores compared to the internal group.
The study shows that patients with an internal locus of control are less depressed compared to patients with fatalistic views on their health/pain in the chance group. The chance dimension of the Multidimensional Health Locus of Control scale was found to be a potential predictor of psychiatric comorbidities such as depression in the chronic pain patient population.
慢性疼痛受行为、认知和情感因素的显著影响。很少有研究调查健康控制点(HLC)——即个人对自身健康控制权所在位置的信念——与慢性疼痛患者的关系。这项前瞻性横断面研究的目的是检验成年持续性疼痛患者中抑郁与健康/疼痛控制点(HLC)之间的关系。
对慢性疼痛患者进行了一系列问卷调查,并对问卷进行评分和分析。根据健康控制点(内控、机遇、他人强大)将患者分为3组,并使用方差分析对其抑郁评分进行检验。
共有131名患者完成了研究:33%属于内控组,39%属于机遇组,28%属于他人强大组。这3组的抑郁评分分别为40(标准差 = 8)、47(标准差 = 10)和42(标准差 = 8)。我们发现机遇组和内控组之间的抑郁评分存在显著差异(P < 0.005),机遇组的抑郁评分高于内控组。
研究表明,与机遇组中对自身健康/疼痛持宿命论观点的患者相比,内控型患者的抑郁程度较低。多维健康控制点量表的机遇维度被发现是慢性疼痛患者群体中抑郁等精神共病的潜在预测指标。