Beks Reinier B, Mellema Jos J, Menendez Mariano E, Chen Neal C, Ring David, Vranceanu Ana Maria
1 Massachusetts General Hospital, Boston, USA.
2 Dell Medical School, Austin, TX, USA.
Hand (N Y). 2018 Mar;13(2):237-243. doi: 10.1177/1558944717697429. Epub 2017 Mar 13.
Mindfulness skills training interventions seem efficacious in increasing physical function and decreasing pain intensity in patients with chronic pain. The relationship of mindfulness and upper extremity complaints in patients presenting to orthopedic surgical practices is not known. The aim of this study was to assess if mindfulness has a relationship to physical function and pain intensity in patients with upper extremity illness.
In this cross-sectional study, a total of 126 patients with a nontraumatic upper extremity condition were asked to fill out questionnaires assessing the 5 facets of mindfulness, pain intensity, and upper extremity physical function, along with clinical and demographic variables prior to their visit with the surgeon.
Nonreactivity to inner experiences was the only facet of mindfulness that was correlated with upper extremity physical function and pain intensity. The overall mindfulness score was correlated with pain intensity only. In multivariable analyses, mindfulness was not associated with either physical function or with pain intensity. Pain interference was the most important predictor of both pain intensity and physical function.
Greater overall mindfulness was associated with lower pain intensity, and greater ability to be nonreactive to inner experiences was associated with both pain intensity and upper extremity physical function in bivariate but not multivariable analyses. Pain interference was the most important predictor of both pain intensity and upper extremity physical function. Psychosocial interventions focused on improving physical function and decreasing pain intensity in this population should focus primarily on reducing pain interference, and secondarily on teaching patients mindfulness skills.
正念技能训练干预似乎能有效提高慢性疼痛患者的身体功能并降低疼痛强度。正念与骨科手术患者上肢不适之间的关系尚不清楚。本研究的目的是评估正念与上肢疾病患者的身体功能和疼痛强度之间是否存在关联。
在这项横断面研究中,共有126例非创伤性上肢疾病患者在就诊外科医生之前,被要求填写评估正念的5个方面、疼痛强度、上肢身体功能以及临床和人口统计学变量的问卷。
对内心体验的不反应性是正念中唯一与上肢身体功能和疼痛强度相关的方面。总体正念得分仅与疼痛强度相关。在多变量分析中,正念与身体功能或疼痛强度均无关联。疼痛干扰是疼痛强度和身体功能的最重要预测因素。
在双变量分析而非多变量分析中,更高的总体正念与更低的疼痛强度相关,对内心体验更强的不反应能力与疼痛强度和上肢身体功能均相关。疼痛干扰是疼痛强度和上肢身体功能的最重要预测因素。针对该人群改善身体功能和降低疼痛强度的心理社会干预应主要侧重于减少疼痛干扰,其次是教授患者正念技能。