Cummings Elizabeth C, van Schalkwyk Gerrit I, Grunschel Beth Dg, Snyder Mary K, Davidson Larry
Yale School of Medicine, New Haven, CT, USA.
Chronic Illn. 2017 Dec;13(4):251-261. doi: 10.1177/1742395317690033. Epub 2017 Jan 24.
Objectives Patients with chronic back pain encounter considerable psychological and social challenges. In particular, the ever-evolving relationship between chronic back pain, sense of self-efficacy, and perceived role in interpersonal relationships merits further investigation. Methods We conducted in-person semi-structured interviews with 20 adult patients attending a specialized interventional spine pain clinic. The interview transcripts were subjected to inductive thematic analysis, and themes were labeled descriptively. Participant responses were intentionally not analyzed within the context of an existing theoretical framework, so that the content of participant responses would directly drive the emphasis of the findings. Results Participants described chronic back pain as a lonely struggle amid diminished capacity to work, enjoy leisure time, and contribute to social relationships. Feelings of needing to handle pain independently contrasted with the reality of having to rely on others for help, and this tension was a source of anxiety. Discussion The experience of chronic back pain was characterized by a conflict between the desire for self-efficacy, a sense of isolation, and the paradoxical need to rely on others. Interventions that allow patients to navigate this struggle by seeking help for their diminished capability, while retaining a sense of autonomy and self-worth, are indicated.
目的 慢性背痛患者面临着相当大的心理和社会挑战。特别是，慢性背痛、自我效能感和在人际关系中所感知的角色之间不断演变的关系值得进一步研究。方法 我们对20名前往一家专门的介入性脊柱疼痛诊所就诊的成年患者进行了面对面的半结构化访谈。对访谈记录进行归纳主题分析，并对主题进行描述性标注。参与者的回答未在现有理论框架的背景下进行分析，以便参与者回答的内容能直接推动研究结果的重点。结果 参与者将慢性背痛描述为一场孤独的斗争，在此过程中工作能力、享受休闲时光的能力以及对社会关系的贡献都有所下降。需要独立应对疼痛的感觉与不得不依赖他人帮助的现实形成对比，这种紧张关系是焦虑的一个来源。讨论 慢性背痛的经历表现为自我效能感的渴望、孤独感以及依赖他人的矛盾需求之间的冲突。建议采取干预措施，让患者在能力下降时通过寻求帮助来应对这种挣扎，同时保持自主感和自我价值感。
