Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, United States.
Pain. 2018 Dec;159(12):2503-2511. doi: 10.1097/j.pain.0000000000001354.
Research suggests that people living with HIV experience levels of pain disproportionate to the general population. Pain is a stressor that can negatively impact health-related quality of life. As the number of people aging with HIV increases, we must understand the dynamics of pain experiences among people living with HIV and how to effectively harness evidence-based treatments and supportive resources to enhance adaptive coping. We used an experience sampling method (also called Ecological Momentary Assessment) to assess moment-to-moment experiences of pain and social support 3 times a day for 7 days in a sample of 109 men living with HIV. Participants also responded to questionnaires assessing attachment-related insecurity and social support. In hierarchical linear modeling analyses controlling for age, race, sexual orientation, and socioeconomic status, we found that experiences of social support were associated with lower subsequent pain within-persons. On the other hand, experiences of pain were not associated with later experiences of social support. Men with higher levels of attachment-related avoidance reported more pain on average. Attachment-related avoidance also moderated the association between moment-to-moment experiences of felt social support on pain. Results suggest that within-persons, experiences of daily social support reduce experiences of pain. Between-persons, attachment style may influence how individuals make use of social support in coping with experiences of pain. These findings imply a need to assess social well-being at the clinic level and also support tailored biopsychosocial approaches to pain management in HIV care settings.
研究表明,HIV 感染者经历的疼痛水平与普通人群不成比例。疼痛是一种应激源,会对与健康相关的生活质量产生负面影响。随着感染 HIV 人数的老龄化增加,我们必须了解 HIV 感染者疼痛体验的动态,以及如何有效地利用基于证据的治疗方法和支持资源来增强适应性应对。我们使用体验抽样方法(也称为生态瞬时评估),在 109 名 HIV 感染者的样本中,每天 3 次,持续 7 天,评估他们的疼痛和社会支持的即时体验。参与者还回答了评估依恋相关不安全感和社会支持的问卷。在控制年龄、种族、性取向和社会经济地位的分层线性模型分析中,我们发现社会支持的体验与个体内随后的疼痛降低有关。另一方面,疼痛体验与后来的社会支持体验无关。依恋相关回避程度较高的男性平均疼痛程度更高。依恋相关回避也调节了即时社会支持体验与疼痛之间的关联。研究结果表明,个体内,日常社会支持体验会减轻疼痛体验。在个体间,依恋风格可能会影响个体在应对疼痛体验时如何利用社会支持。这些发现意味着需要在诊所层面评估社会福利,并支持在 HIV 护理环境中针对疼痛管理的量身定制的生物心理社会方法。