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活动节奏的障碍:评估、与活动及功能的关系

Obstacles to activity pacing: assessment, relationship to activity and functioning.

作者信息

Cane Douglas, McCarthy Mary, Mazmanian Dwight

机构信息

Pain Management Unit, Nova Scotia Health Authority, Halifax, NS, Canada.

Department of Psychology, Lakehead University, Thunder Bay, ON, Canada.

出版信息

Pain. 2016 Jul;157(7):1508-1514. doi: 10.1097/j.pain.0000000000000553.

Abstract

Activity pacing is frequently included among the strategies provided to individuals with chronic pain to manage pain and improve functioning. Individuals with chronic pain may, however, limit their use of activity pacing because they perceive significant obstacles to its use. This study describes the development of a measure to assess obstacles to activity pacing and examines the relationship of this measure to activity patterns and functioning. A sample of 637 individuals with chronic pain completed items describing potential obstacles to activity pacing as part of their pretreatment assessment. Item analyses were used to construct a 14-item measure of obstacles to activity pacing. A subset of these individuals completed the measure again after completion of a group treatment program. The resulting measure demonstrated excellent internal consistency and was minimally affected by social desirability. Correlations with measures of activity and psychosocial functioning provided initial construct validity for the measure. Sex differences were found with women initially identifying more obstacles to activity pacing. Fewer obstacles were identified by both men and women after treatment, and these changes were related to modest changes in activity patterns and functioning. The present results identify a number of obstacles that may limit the use of activity pacing by individuals with chronic pain. Treatment may result in a decrease in the number of obstacles identified, and this change is related to changes in the individual's activity pattern and psychosocial functioning.

摘要

活动节奏调整常常被纳入为慢性疼痛患者提供的管理疼痛和改善功能的策略之中。然而,慢性疼痛患者可能会限制对活动节奏调整的运用,因为他们认为在使用过程中存在重大障碍。本研究描述了一种评估活动节奏调整障碍的测量方法的开发,并考察了该测量方法与活动模式及功能之间的关系。637名慢性疼痛患者作为样本,在其治疗前评估中完成了描述活动节奏调整潜在障碍的项目。通过项目分析构建了一个包含14个条目的活动节奏调整障碍测量方法。这些患者中的一部分在完成一个团体治疗项目后再次完成了该测量。最终得到的测量方法显示出极佳的内部一致性,且受社会期望的影响极小。与活动及心理社会功能测量方法的相关性为该测量方法提供了初步的结构效度。研究发现存在性别差异,女性最初识别出的活动节奏调整障碍更多。治疗后男性和女性识别出的障碍都减少了,且这些变化与活动模式和功能的适度改变有关。目前的研究结果确定了一些可能会限制慢性疼痛患者使用活动节奏调整的障碍。治疗可能会使识别出的障碍数量减少,且这种变化与个体活动模式和心理社会功能的变化有关。

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