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生活满意度通过疼痛灾难化调节疼痛强度对疼痛干扰的间接效应。

Satisfaction with life moderates the indirect effect of pain intensity on pain interference through pain catastrophizing.

机构信息

Hand and Upper Extremity Service, Massachusetts General Hospital.

Department of Orthopedic Surgery, Dell Medical School, The University of Texas at Austin.

出版信息

J Consult Clin Psychol. 2018 Mar;86(3):231-241. doi: 10.1037/ccp0000283.

Abstract

OBJECTIVE

Satisfaction with life buffers the effect of stress on health, but its role in the mechanism through which pain may impact engagement in activities of daily living is not known. We tested whether satisfaction with life protects against engaging in pain catastrophizing and through this explains individual differences in the extent to which pain interferes with activities of daily living.

METHOD

One-hundred and 42 patients with upper extremity musculoskeletal illness participated in this cross-sectional study and completed the PROMIS pain intensity, PROMIS pain interference, pain catastrophizing scale (PCS), satisfaction with life scale (SWLS), and demographic variables.

RESULTS

A simple mediation model confirmed that the indirect effect of pain intensity on pain interference through PCS was 35.9% of the total effect. A moderated mediation analysis showed that the indirect effect of pain intensity on pain interference through PCS was differentially moderated by SWLS after controlling for relevant covariates. As satisfaction with life increased from low to moderate to high, a smaller proportion of the effect of pain intensity on pain interference (41.6%, 26.1%, and 10.5%) was carried through PCS, such that at the highest satisfaction with life, the indirect effect becomes completely nonsignificant.

CONCLUSIONS

Satisfaction with life appears to buffer the effect of pain in individuals with upper extremity musculoskeletal illness. If replicated through longitudinal designs, results suggest that clinical interventions focused on increasing satisfaction with life, such as acceptance and commitment therapy, mindfulness training, gratitude, and other positive psychology skills, may improve outcomes in this population. (PsycINFO Database Record

摘要

目的

生活满意度可以缓冲压力对健康的影响,但它在疼痛影响日常生活活动参与的机制中所起的作用尚不清楚。我们检验了生活满意度是否可以预防出现对疼痛的灾难化认知,以及通过这种方式,解释了疼痛对日常生活的干扰程度存在个体差异的原因。

方法

142 名上肢肌肉骨骼疾病患者参与了这项横断面研究,并完成了 PROMIS 疼痛强度、PROMIS 疼痛干扰、疼痛灾难化量表(PCS)、生活满意度量表(SWLS)以及人口统计学变量的评估。

结果

简单的中介模型证实,疼痛强度通过 PCS 对疼痛干扰的间接效应占总效应的 35.9%。调节中介分析显示,在控制了相关协变量后,SWLS 对 PCS 中介了疼痛强度对疼痛干扰的间接效应存在差异调节。随着生活满意度从低到中等到高,疼痛强度对疼痛干扰的效应通过 PCS 的比例(41.6%、26.1%和 10.5%)逐渐减小,以至于在生活满意度最高时,间接效应变得完全不显著。

结论

生活满意度似乎可以缓冲上肢肌肉骨骼疾病患者的疼痛效应。如果通过纵向设计得到复制,结果表明,以增加生活满意度为重点的临床干预措施,如接受与承诺疗法、正念训练、感恩和其他积极心理学技巧,可能会改善这一人群的预后。

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