Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas.
Department of Family and Community Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA.
Pain Med. 2019 Aug 1;20(8):1509-1518. doi: 10.1093/pm/pny197.
The purpose of this study was to examine the effect of pain severity on activity levels and physical disability in the context of high pain acceptance. We hypothesized that pain acceptance moderates the effect of pain severity on general activity and physical disability, such that at higher levels of acceptance, the deleterious effect of pain is mitigated.
Two hundred seven patients with chronic pain were recruited from three clinics in a large southwestern military treatment facility. Participants completed an anonymous self-report battery of standardized measures, including the Chronic Pain Acceptance Questionnaire, modified Oswestry Disability Index, and Pain Severity and General Activity subscales of the West Haven-Yale Multidimensional Pain Inventory.
Chronic pain acceptance was found to significantly moderate relations between pain severity and general activity (b = 0.0061, t(198) = 2.75, P = 0.007, 95% confidence interval [CI] = 0.002 to 0.011) and pain severity and disability (b = 0.036, t(193) = -2.564, P = 0.011, 95% CI = -0.063 to -0.008). In the context of higher acceptance, the negative effect of pain on activity and disability appeared reduced. Conversely, in the context of low acceptance, the effect of pain on disability appeared accentuated at all levels of pain severity.
Higher acceptance mitigated both activity level and disability in a military-affiliated clinical sample of patients with chronic pain. Results further establish the role of acceptance in relation to functioning in a unique sample of people with chronic pain. These findings have implications for understanding and enhancing functioning in chronic pain populations.
本研究旨在考察在高疼痛接受度的背景下，疼痛严重程度对活动水平和身体残疾的影响。我们假设疼痛接受度调节了疼痛严重度对一般活动和身体残疾的影响，即接受度越高，疼痛的不良影响就会减轻。
从西南地区一家大型军事治疗机构的三个诊所招募了 207 名慢性疼痛患者。参与者完成了一套匿名的自我报告标准化量表，包括慢性疼痛接受问卷、改良 Oswestry 残疾指数以及西 Haven-Yale 多维疼痛量表的疼痛严重度和一般活动分量表。
发现慢性疼痛接受度显著调节了疼痛严重度与一般活动（b = 0.0061，t（198）= 2.75，P = 0.007，95%置信区间 [CI] = 0.002 至 0.011）以及疼痛严重度与残疾（b = 0.036，t（193）= -2.564，P = 0.011，95% CI = -0.063 至 -0.008）之间的关系。在较高接受度的情况下，疼痛对活动和残疾的负面影响似乎减轻了。相反，在接受度较低的情况下，疼痛对残疾的影响在所有疼痛严重度水平上都显得更加明显。
在一个有慢性疼痛的军事相关临床样本中，较高的接受度减轻了活动水平和残疾。结果进一步确立了接受度与慢性疼痛人群功能之间的关系。这些发现对理解和增强慢性疼痛人群的功能具有重要意义。
