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疼痛信念在一般适应能力和慢性背痛功能障碍之间起中介作用。

Pain beliefs mediate relations between general resilience and dysfunction from chronic back pain.

机构信息

Key Laboratory of Cognition and Personality.

出版信息

Rehabil Psychol. 2018 Nov;63(4):604-611. doi: 10.1037/rep0000244. Epub 2018 Sep 13.

DOI:10.1037/rep0000244
PMID:30211606
Abstract

PURPOSE/OBJECTIVE: A substantial percentage of people affected by chronic back pain maintain a high quality of life despite ongoing discomfort. Presumably, more resilient persons view pain and their capacities to manage it in a manner that mitigates pain-related dysfunction. Research Method/Design: To test this premise, 307 mainland Chinese adults with chronic back pain (189 women, 118 men) completed self-report measures of psychological resilience, pain beliefs (challenge appraisals of pain, pain self-efficacy, pain catastrophizing) and pain-related dysfunction (i.e., pain intensity, disability, affective distress, depression) within a cross-sectional research design.

RESULTS

Structural equation modeling indicated elevations in general psychological resilience were related to more frequent appraisals of pain as a challenge, higher pain self-efficacy levels, and lower pain catastrophizing levels. In turn, resilience, pain self-efficacy, and pain catastrophizing were linked to pain-related dysfunction while challenge appraisals were not.

CONCLUSIONS/IMPLICATIONS: Together, results underscored specific pain beliefs underlying the pathway between resilience and reduced dysfunction from chronic back pain. Aside from evaluating dysfunctional expectancies (e.g., pain catastrophizing) and outcomes, practitioners and researchers should consider beliefs about personal effectiveness in managing pain within assessment and treatment protocols of chronic back pain. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

摘要

目的/目标:尽管存在持续的不适,但相当一部分慢性背痛患者仍保持着较高的生活质量。据推测,更有韧性的人会以减轻与疼痛相关的功能障碍的方式来看待疼痛及其管理能力。

研究方法/设计:为了验证这一前提,307 名中国大陆慢性背痛患者(189 名女性,118 名男性)完成了自我报告的心理韧性、疼痛信念(对疼痛的挑战评估、疼痛自我效能、疼痛灾难化)和与疼痛相关的功能障碍(即疼痛强度、残疾、情感困扰、抑郁)的测量,采用横断面研究设计。

结果

结构方程模型表明,一般心理韧性的提高与更频繁地将疼痛评估为挑战、更高的疼痛自我效能水平和更低的疼痛灾难化水平有关。反过来,韧性、疼痛自我效能和疼痛灾难化与疼痛相关的功能障碍有关,而挑战评估则没有。

结论/意义:总之,研究结果强调了韧性与慢性背痛减轻功能障碍之间的途径背后的特定疼痛信念。除了评估功能失调的期望(例如,疼痛灾难化)和结果外,临床医生和研究人员还应考虑在慢性背痛的评估和治疗方案中,将个人管理疼痛的能力纳入信念。(APA,2018 年,所有权利保留)。

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