School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
Psychooncology. 2018 Oct;27(10):2442-2449. doi: 10.1002/pon.4848. Epub 2018 Aug 31.
The aims of this study were to investigate associations between attachment and the presence of persistent pain in women following treatment for breast cancer and to investigate the relationship between attachment, pain, and quality of life (QOL) in women with persistent pain.
Women (N = 335) previously diagnosed with primary non-metastatic breast cancer completed an online survey with measures of attachment, pain, QOL, demographics, and medical history. Variables were compared between women with (N = 128) and without (N = 207) persistent pain. For those reporting pain, regression analyses were conducted to investigate relationships between attachment, pain, and QOL.
Higher attachment anxiety, but not attachment avoidance, was related to the presence of persistent pain. Among women with persistent pain, associations between attachment anxiety and avoidance and greater pain intensity were lost when pain catastrophizing was considered in analysis. Significant associations between attachment and diminished QOL and perceived effectiveness of pain management were identified in multivariate analysis.
These findings extend the available literature regarding associations between pain and attachment insecurity. In women with pain after breast cancer treatment, attachment anxiety and avoidance were associated with negative pain and QOL outcomes. Further attention regarding the use of attachment-informed approaches in supporting women following breast cancer treatment is indicated.
本研究旨在探讨乳腺癌治疗后持续性疼痛女性依恋与持续性疼痛之间的关系，并探讨依恋、疼痛与持续性疼痛女性生活质量（QOL）之间的关系。
先前被诊断为原发性非转移性乳腺癌的女性（N=335）完成了一项在线调查，内容包括依恋、疼痛、QOL、人口统计学和病史。对有（N=128）和无（N=207）持续性疼痛的女性进行了变量比较。对于报告疼痛的女性，进行了回归分析，以探讨依恋、疼痛和 QOL 之间的关系。
较高的依恋焦虑，但不是依恋回避，与持续性疼痛的存在有关。在有持续性疼痛的女性中，当在分析中考虑疼痛灾难化时，依恋焦虑和回避与更高的疼痛强度之间的关联就会消失。在多变量分析中，依恋与较差的 QOL 和疼痛管理效果感知之间存在显著关联。
这些发现扩展了有关疼痛与依恋不安全感之间关联的现有文献。在乳腺癌治疗后有疼痛的女性中，依恋焦虑和回避与负面的疼痛和 QOL 结果有关。进一步关注在支持乳腺癌治疗后女性时使用基于依恋的方法是必要的。
