Burns John W, Post Kristina M, Smith David A, Porter Laura S, Buvanendran Asokumar, Fras Anne Marie, Keefe Francis J
Department of Psychiatry and Behavioral Science, Rush University Medical Center, Chicago, Illinois.
Department of Psychology, University of La Verne, La Verne, California.
J Pain. 2019 Oct;20(10):1176-1186. doi: 10.1016/j.jpain.2019.04.001. Epub 2019 Apr 5.
Patient beliefs and perceptions about the causes and meaning of their chronic pain are related to their psychosocial functioning. Beliefs and perceptions about chronic pain held by spouses may also be related to patient functioning. We used a laboratory procedure to evaluate whether spouse beliefs about and perceptions of chronic pain were related to spouse negative responses toward patients with chronic low back pain during a conflictual discussion and to their attributions about patient pain behavior during a subsequent pain-induction task. Patients (n = 71) and their spouses (n = 71) participated in a 10-minute discussion followed by the patient undergoing a 10-minute structured pain behavior task. Findings were that a) spouse perceptions that patient's pain was a mystery were significantly related to greater patient perceived spouse critical/invalidating responses toward the patient during the discussion; and b) spouse perceptions that patient's pain was a mystery were related to internal and negative attributions spouses made while observing patients display pain behaviors during the structured pain behavior task. Inasmuch as both spouse critical/invalidating speech toward patients and negative attributions regarding the cause of patient behavior are related to poor patient functioning, spouse uncertainty about the source and potential legitimacy of their partner's pain may play crucial roles in affecting patient well-being. PERSPECTIVE: Spouse beliefs about and perceptions of patient chronic pain were related to spouse behavior toward patients during a discussion and to attributions explaining patient pain during physical activity. If spouse confusion and doubt about patient pain is related to negative behavior and attributions, then modifying these perceptions may be a fundamental intervention target.
患者对其慢性疼痛的病因及意义的信念和认知与他们的心理社会功能相关。配偶对慢性疼痛的信念和认知也可能与患者的功能状况有关。我们采用一种实验室程序来评估配偶对慢性疼痛的信念和认知是否与在冲突性讨论中配偶对慢性下腰痛患者的负面反应以及在随后的疼痛诱发任务中他们对患者疼痛行为的归因有关。患者（n = 71）及其配偶（n = 71）参与了一场10分钟的讨论，随后患者进行了一项10分钟的结构化疼痛行为任务。研究结果如下：a）配偶认为患者的疼痛是个谜，这与在讨论中患者感受到配偶对其更具批评性/否定性的反应显著相关；b）配偶认为患者的疼痛是个谜，这与配偶在结构化疼痛行为任务中观察患者表现出疼痛行为时所做出的内在和负面归因有关。鉴于配偶对患者的批评性/否定性言语以及对患者行为原因的负面归因都与患者功能不佳有关，配偶对其伴侣疼痛的来源和潜在合理性的不确定性可能在影响患者幸福感方面起着关键作用。观点：配偶对患者慢性疼痛的信念和认知与讨论期间配偶对患者的行为以及对体育活动中患者疼痛的归因有关。如果配偶对患者疼痛的困惑和怀疑与负面行为及归因有关，那么改变这些认知可能是一个基本的干预目标。
