McMillan Gail, Dixon Diane
Department of Psychology, Carleton University, Ottawa, ON, Canada.
Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
Front Psychol. 2020 Sep 4;11:516485. doi: 10.3389/fpsyg.2020.516485. eCollection 2020.
Motivational and self-regulatory processes during goal pursuit may account for activity patterns in people with chronic pain. This article describes a series of N-of-1 observational studies designed to investigate the influence of goal-related factors on fluctuations in motivation to conserve resources and objectively measured activity levels.
Four participants with chronic pain who attended a formal pain management program (PMP; 41-59 years old; three female) were recruited and completed digital daily diaries for 11-12 weeks. The daily dairies, delivered via text message, measured self-regulatory fatigue, goal self-efficacy, goal striving, perceived demands, pain, and motivation to conserve resources. Continuously worn accelerometers measured physical activity and sedentary time. Analyses were conducted individually for each participant. The effects of self-regulatory fatigue, goal self-efficacy, goal striving, perceived demands, and pain on motivation to conserve resources, physical activity and sedentary time were assessed with dynamic regression modeling.
Different patterns of associations between the predictors and outcomes were observed across participants. Most associations occurred concurrently (e.g., on the same day). Perceived demand was the only variable to predict motivation to conserve resources, physical activity, and sedentary time. Motivation to conserve resources and sedentary time were most frequently predicted by goal striving and perceived demand. Self-regulatory fatigue and pain intensity both predicted motivation to conserve resources in two participants and sedentary time in one participant. Motivation to conserve resources predicted sedentary time in two participants.
This study was the first to examine the impact of fluctuations in self-regulatory processes on motivation to conserve resources and objective activity levels within individuals with chronic pain. The results generally supported recent affective-motivational views of goal pursuit in chronic pain. This study demonstrated that N-of-1 observational studies can be conducted with patients during a PMP using digital technologies. The use of these approaches may facilitate the application of personalized medicine.
目标追求过程中的动机和自我调节过程可能解释慢性疼痛患者的活动模式。本文描述了一系列单病例观察研究，旨在调查与目标相关的因素对保存资源动机波动和客观测量的活动水平的影响。
招募了四名参加正式疼痛管理项目（PMP；41 - 59岁；三名女性）的慢性疼痛患者，并让他们在11 - 12周内完成数字日记。通过短信发送的每日日记测量自我调节疲劳、目标自我效能感、目标努力、感知需求、疼痛以及保存资源的动机。持续佩戴的加速度计测量身体活动和久坐时间。对每位参与者分别进行分析。使用动态回归模型评估自我调节疲劳、目标自我效能感、目标努力、感知需求和疼痛对保存资源动机、身体活动和久坐时间的影响。
在参与者中观察到预测因素与结果之间存在不同的关联模式。大多数关联同时发生（例如，在同一天）。感知需求是预测保存资源动机、身体活动和久坐时间的唯一变量。目标努力和感知需求最常预测保存资源的动机和久坐时间。自我调节疲劳和疼痛强度在两名参与者中预测了保存资源的动机，在一名参与者中预测了久坐时间。保存资源的动机在两名参与者中预测了久坐时间。
本研究首次考察了自我调节过程波动对慢性疼痛患者保存资源动机和客观活动水平的影响。结果总体上支持了近期关于慢性疼痛中目标追求的情感 - 动机观点。本研究表明，可以在PMP期间使用数字技术对患者进行单病例观察研究。这些方法的使用可能有助于个性化医疗的应用。
