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缓冲还是放大?社会支持对老年人功能自主/依赖与慢性疼痛体验的纵向影响。

Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults' chronic pain experiences.

作者信息

Matos Marta, Bernardes Sónia F, Goubert Liesbet, Beyers Wim

机构信息

ISCTE-Instituto Universitário de Lisboa.

Department of Experimental-Clinical and Health Psychology, Ghent University.

出版信息

Health Psychol. 2017 Dec;36(12):1195-1206. doi: 10.1037/hea0000512. Epub 2017 Jun 26.

Abstract

OBJECTIVE

This longitudinal study aimed to investigate (a) the moderating role of formal social support for functional autonomy versus dependence on the relationship between pain intensity and pain-related disability among older adults with chronic pain and (b) the mediating role of pain-related self-efficacy and pain-related fear in this moderation.

METHOD

One hundred and seventy older adults (Mage = 78.0; SD = 8.7) with chronic musculoskeletal pain participated in a 3-month prospective study, with 3 measurement moments. Participants filled out the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Portuguese versions of the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire, and the Tampa Scale of Kinesiophobia.

RESULTS

Using structural equation modeling, it was found that perceived promotion of autonomy, at Time 1, moderated the relationship between pain intensity (T1) and pain-related disability (T2); this moderation was fully mediated by pain-related self-efficacy (T2). Perceived promotion of dependence was not a significant moderator.

CONCLUSIONS

These findings highlight the importance of social support for functional autonomy in buffering the impact of pain intensity on older adults' pain-related disability. Also, they clarify the role of pain-related self-efficacy in this effect. Implications for the development of intervention programs, with formal caregivers, to reduce the impact of chronic pain on older adults' healthy ageing process, are discussed. (PsycINFO Database Record

摘要

目的

本纵向研究旨在探讨(a)正式社会支持在慢性疼痛老年人中对功能自主性与疼痛强度和疼痛相关残疾之间关系的调节作用,以及(b)疼痛相关自我效能感和疼痛相关恐惧在这种调节作用中的中介作用。

方法

170名患有慢性肌肉骨骼疼痛的老年人(年龄中位数=78.0;标准差=8.7)参与了一项为期3个月的前瞻性研究,有3个测量时间点。参与者填写了《疼痛中自主性与依赖性的正式社会支持量表》、葡萄牙语版的《简明疼痛量表》、《疼痛自我效能量表》和《坦帕运动恐惧量表》。

结果

使用结构方程模型发现,在时间1时感知到的自主性促进调节了疼痛强度(T1)与疼痛相关残疾(T2)之间的关系;这种调节作用完全由疼痛相关自我效能感(T2)介导。感知到的依赖性促进不是一个显著的调节因素。

结论

这些发现强调了社会支持对功能自主性在缓冲疼痛强度对老年人疼痛相关残疾影响方面的重要性。此外,它们阐明了疼痛相关自我效能感在这种效应中的作用。讨论了与正式照顾者一起制定干预计划以减少慢性疼痛对老年人健康衰老过程影响的意义。(PsycINFO数据库记录)

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