Salt Elizabeth, Crofford Leslie J, Segerstrom Suzanne
University of Kentucky, College of Nursing, Lexington, Kentucky.
Vanderbilt University, Department of Medicine, Nashville, Tennessee.
Pain Manag Nurs. 2017 Aug;18(4):243-249. doi: 10.1016/j.pmn.2017.04.004. Epub 2017 Jun 7.
To improve function and quality of life in patients with chronic pain, a prevalent and costly condition, an understanding of the relationships among well-being, physical activity, depression, and life purpose with pain is needed. Because of the role loss experienced by people with chronic pain, activities such as volunteering could have an important role in improving health and well-being. In one study, chronic pain patients who participated in volunteer activities reported both decreased pain and "a sense of purpose." The aim of this study is to test the relationships among pain and well-being, physical activity, depression, and life purpose and then to determine if volunteering activities mediated or moderated these relationships. This observational study was conducted in a large university setting in Kentucky and used a sample of 200 women older than age 50. We found that people with higher pain were more depressed and had lower life purpose and well-being. People who volunteered less had more pain, lower perceived life purpose, more depressive symptoms, and decreased physical activity. Volunteer activities did have a significant mediating effect on the relationship between pain and depression; approximately 9% of the relationship between pain and depression can be accounted for by volunteering. Moderation by volunteering was found between pain and life purpose. We identified important relationships among pain, volunteering, and health outcomes and found that volunteering has a role in improving depressive symptoms and life purpose in women with pain.
为改善慢性疼痛患者的功能和生活质量（慢性疼痛是一种普遍且代价高昂的病症），需要了解幸福感、身体活动、抑郁和生活目标与疼痛之间的关系。由于慢性疼痛患者会经历角色丧失，像志愿服务这样的活动在改善健康和幸福感方面可能发挥重要作用。在一项研究中，参与志愿活动的慢性疼痛患者报告称疼痛减轻且有了“目标感”。本研究的目的是测试疼痛与幸福感、身体活动、抑郁和生活目标之间的关系，然后确定志愿活动是否介导或调节了这些关系。这项观察性研究在肯塔基州的一所大型大学进行，样本为200名50岁以上的女性。我们发现，疼痛程度较高的人更易抑郁，生活目标感和幸福感更低。志愿活动参与较少的人疼痛更多，感知到的生活目标更低，抑郁症状更多，身体活动也更少。志愿活动确实对疼痛与抑郁之间的关系有显著的中介作用；疼痛与抑郁之间约9%的关系可由志愿活动来解释。在疼痛与生活目标之间发现了志愿活动的调节作用。我们确定了疼痛、志愿活动和健康结果之间的重要关系，并发现志愿活动在改善疼痛女性的抑郁症状和生活目标方面发挥作用。
