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下肢慢性缺血或类风湿关节炎患者对疼痛的感知与疼痛及疼痛控制信念和A型行为模式的关系

Perception vs pain and beliefs about pain control and Type A behavior pattern in patients with chronic ischemia of lower extremities or with rheumatoid arthritis.

作者信息

Kadłubowska Monika, Bąk Ewelina, Marcisz Czesław, Kózka Maria, Michalik Anna, Kolonko Jolanta, Krawczyk Bożena, Dobrzyń-Matusiak Dorota, Kapusta-Nowak Zofia

机构信息

University of Bielsko-Biała, Department of Nursing, Faculty of Health Sciences, Bielsko-Biała, Poland,

Medical University of Silesia, Department of Gerontology and Geriatric Nursing, School of Health Sciences, Katowice, Poland.

出版信息

J Pain Res. 2018 Nov 29;11:3051-3059. doi: 10.2147/JPR.S182703. eCollection 2018.

Abstract

OBJECTIVE

The study aimed at determining the experience of pain taking into consideration beliefs about pain control, Type A behavior pattern and sociodemographic factors in patients with chronic ischemia of the lower extremities or with rheumatoid arthritis (RA).

METHODS

The study enrolled 100 patients with peripheral arterial disease (PAD) and 100 patients with RA. The subjective sensation of pain was assessed using the Visual Analog Scale (VAS); beliefs about pain control were analyzed using the Beliefs about Pain Control Questionnaire (BPCQ), taking into consideration internal factors, the influence of physicians and accidental events (chance); and Type A behavior features (haste and competition) were analyzed using the Framingham Type A Scale. The multiple regression model was used to assess associations between the experienced pain and the BPCQ value, the Framingham Type A Scale and sociodemographic factors.

RESULTS

The pain intensity degree was found to be comparable in patients with PAD and with RA. The median determined using the VAS was 5.75 in both of the studied groups. In patients with PAD, lower VAS values were associated with the BPCQ - internal factors (<0.05) whereas a higher VAS value was related to the BPCQ - physicians' influence (<0.001). In patients with RA, a higher VAS value was associated with BPCQ - physicians' influence (<0.05), disease duration (<0.05) and smoking cigarettes (<0.05).

CONCLUSION

Experiencing pain by patients with chronic ischemia of the lower extremities occurs at a moderate level and is beneficially connected with the internal factors and adversely connected with the external factors of beliefs about pain control. Patients with RA reported pain ailments of a moderate level in connection with the adverse influence of the external factors of beliefs about pain control, the duration of the disease and smoking cigarettes. Experiencing pain by patients with chronic ischemia of the lower extremities and RA does not seem to be related to Type A behavior.

摘要

目的

本研究旨在考虑下肢慢性缺血患者或类风湿关节炎(RA)患者对疼痛控制的信念、A型行为模式和社会人口学因素,来确定其疼痛体验。

方法

本研究纳入了100例外周动脉疾病(PAD)患者和100例RA患者。使用视觉模拟量表(VAS)评估疼痛的主观感受;使用疼痛控制信念问卷(BPCQ)分析对疼痛控制的信念,同时考虑内部因素、医生的影响和偶然事件(机遇);使用弗雷明汉A型量表分析A型行为特征(匆忙和竞争)。采用多元回归模型评估疼痛体验与BPCQ值、弗雷明汉A型量表及社会人口学因素之间的关联。

结果

发现PAD患者和RA患者的疼痛强度程度相当。两个研究组使用VAS确定的中位数均为5.75。在PAD患者中,较低的VAS值与BPCQ - 内部因素相关(<0.05),而较高的VAS值与BPCQ - 医生的影响相关(<0.001)。在RA患者中,较高的VAS值与BPCQ - 医生的影响(<0.05)、疾病持续时间(<0.05)和吸烟(<0.05)相关。

结论

下肢慢性缺血患者的疼痛体验处于中等水平,与疼痛控制信念的内部因素呈有益关联,与外部因素呈不利关联。RA患者报告的疼痛疾病处于中等水平,与疼痛控制信念的外部因素的不利影响、疾病持续时间和吸烟有关。下肢慢性缺血患者和RA患者的疼痛体验似乎与A型行为无关。

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