Ankawi Brett, Slepian P Maxwell, Himawan Lina K, France Christopher R
Department of Psychology, Ohio University, Athens, Ohio.
Department of Psychology, Ohio University, Athens, Ohio.
J Pain. 2017 Aug;18(8):984-993. doi: 10.1016/j.jpain.2017.03.013. Epub 2017 Apr 18.
Psychosocial factors that protect against negative outcomes for individuals with chronic pain have received increased attention in recent years. Pain resilience, or the ability to maintain behavioral engagement and regulate emotions as well as cognitions despite prolonged or intense pain, is one such factor. A measure of pain-specific resilience, the Pain Resilience Scale, was previously identified as a better predictor of acute pain tolerance than general resilience. The present study sought to validate this measure in a chronic pain sample, while also furthering understanding of the role of pain resilience compared with other protective factors. Participants with chronic pain completed online questionnaires to assess factors related to positive pain outcomes, pain vulnerability, pain intensity, and quality of life. A confirmatory factor analysis confirmed the 2-factor structure of the Pain Resilience Scale previously observed among respondents without chronic pain, although one item from each subscale was dropped in the final version. For this chronic pain sample, structural equation modeling showed that pain resilience contributes unique variance to a model including pain acceptance and pain self-efficacy in predicting quality of life and pain intensity. Further, pain resilience was a better fit in this model than general resilience, strengthening the argument for assessing pain resilience over general resilience.
A modified version of the Pain Resilience Scale retained the original factor structure when tested in a chronic pain sample. Construct validity was supported by expected relationships with pain-related protective and vulnerability measures. Further, a model including positive pain constructs showed that pain resilience accounts for unique variability when predicting quality of life and pain intensity.
近年来,能够预防慢性疼痛患者出现负面结果的社会心理因素受到了更多关注。疼痛恢复力,即尽管存在长期或剧烈疼痛,仍能保持行为参与、调节情绪和认知的能力,就是这样一个因素。一种针对疼痛的特定恢复力测量工具——疼痛恢复力量表,先前被确定为比一般恢复力更好的急性疼痛耐受性预测指标。本研究旨在验证该测量工具在慢性疼痛样本中的有效性,同时进一步了解疼痛恢复力与其他保护因素相比所起的作用。慢性疼痛患者完成了在线问卷,以评估与积极疼痛结果、疼痛易感性、疼痛强度和生活质量相关的因素。验证性因素分析证实了疼痛恢复力量表的两因素结构,该结构先前在无慢性疼痛的受访者中观察到,不过最终版本中每个子量表都删除了一个项目。对于这个慢性疼痛样本,结构方程模型表明,在预测生活质量和疼痛强度时,疼痛恢复力在一个包括疼痛接纳和疼痛自我效能感的模型中贡献了独特的方差。此外,在这个模型中,疼痛恢复力比一般恢复力更合适,这强化了评估疼痛恢复力优于一般恢复力的观点。
在慢性疼痛样本中进行测试时,疼痛恢复力量表的修改版保留了原有的因素结构。与疼痛相关的保护和易感性测量工具的预期关系支持了结构效度。此外,一个包括积极疼痛结构的模型表明,在预测生活质量和疼痛强度时,疼痛恢复力解释了独特的变异性。