Faculty of Sport and Health Sciences, University of Jyvaskyla, P.O. Box 35, 40014, Jyvaskyla, Finland.
Department of Rehabilitation Medicine, VU University Medical Center Amsterdam, Amsterdam, Netherlands.
Aging Clin Exp Res. 2019 Mar;31(3):377-383. doi: 10.1007/s40520-018-0978-x. Epub 2018 Jun 6.
As the population ages, the number of people with chronic diseases increases. Frequently, older people suffer from joint pain together with other chronic diseases, which can lead to decreased physical functioning.
To investigate the associations of the changes in cognitive appraisals, coping strategies and pain with the change in physical functioning in older people, who have chronic pain and chronic diseases.
Elderly persons (n = 407, mean age 77 years, and 62% female), with self-reported joint pain and at least two chronic diseases, filled in questionnaires about cognitive appraisals, coping strategies, pain intensity and physical functioning at baseline, at 6- and 18-month follow-ups. The associations of change in physical functioning with changes in cognitive appraisals, coping strategies and pain were modelled using generalized estimating equations (GEE).
Increase in pain, in negative thinking about the consequences of pain, and in activity avoidance and decrease in self-efficacy beliefs were associated with a decline in physical functioning.
Observed mean changes were small but large inter-individual variability was seen. This shows that cognitive appraisals and coping strategies are malleable. Statistical model of change clarifies the direction of longitudinal associations.
The longitudinal findings suggest that joint pain, cognitive appraisals and coping strategies may determine physical functioning in older people who have chronic pain and comorbidity.
随着人口老龄化，慢性病患者的数量不断增加。老年人经常同时患有关节疼痛和其他慢性病，这可能导致身体机能下降。
调查认知评估、应对策略和疼痛变化与患有慢性疼痛和慢性病的老年人身体功能变化之间的关系。
407 名年龄在 77 岁（平均年龄）、62%为女性的老年人，自述有关节疼痛和至少两种慢性病，在基线、6 个月和 18 个月随访时填写了认知评估、应对策略、疼痛强度和身体功能问卷。使用广义估计方程（GEE）对身体功能变化与认知评估、应对策略和疼痛变化之间的关系进行建模。
疼痛增加、对疼痛后果的消极思维增加、活动回避增加以及自我效能感下降与身体功能下降有关。
观察到的平均变化很小，但个体间的差异很大。这表明认知评估和应对策略是可塑的。变化的统计模型阐明了纵向关联的方向。
纵向研究结果表明，关节疼痛、认知评估和应对策略可能决定患有慢性疼痛和合并症的老年人的身体功能。
