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复杂区域疼痛综合征中疾病认知与疼痛及残疾有关吗?一项横断面研究。

Are Illness Perceptions Associated with Pain and Disability in Complex Regional Pain Syndrome? A Cross-Sectional Study.

作者信息

Antunovich Dana R, Horne Juliette C, Tuck Natalie L, Bean Debbie J

机构信息

Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand.

The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand.

出版信息

Pain Med. 2021 Feb 4;22(1):100-111. doi: 10.1093/pm/pnaa320.

Abstract

OBJECTIVE

Complex regional pain syndrome (CRPS) is a complex and often poorly understood condition, and people with CRPS will have diverse beliefs about their symptoms. According to the self-regulation model, these beliefs (termed "illness perceptions") influence health behaviors and outcomes. Previous studies have found that psychological factors influence CRPS outcomes, but few studies have investigated CRPS patients' illness perceptions specifically. The present study examined whether illness perceptions were related to pain intensity and other relevant outcomes in people with CRPS.

METHODS

In this cross-sectional study, 53 patients with CRPS (type 1 and type 2) completed questionnaires assessing illness perceptions, pain, disability, and psychological factors. Multiple regression analyses were used to determine whether illness perceptions were associated with pain intensity, disability, depression, and kinesiophobia, after controlling for possible covariates (including clinical and demographic factors, pain catastrophizing, and negative affect).

RESULTS

Negative illness perceptions were associated with greater pain, disability, and kinesiophobia, but not depression. Specifically, attributing more symptoms to CRPS (more negative illness identity perceptions) was associated with greater pain intensity, and reporting a poorer understanding of CRPS (lower illness coherence scores) was associated with greater disability and kinesiophobia.

CONCLUSIONS

Patients with CRPS with more negative illness perceptions (particularly perceptions indicating a poor understanding of their condition) also experience greater pain, disability, and kinesiophobia. Future research could investigate whether altering CRPS patients' illness perceptions influences clinical outcomes.

摘要

目的

复杂性区域疼痛综合征(CRPS)是一种复杂且往往难以理解的病症,患有CRPS的人对其症状会有不同的看法。根据自我调节模型,这些看法(称为“疾病认知”)会影响健康行为和结果。先前的研究发现心理因素会影响CRPS的结果,但很少有研究专门调查CRPS患者的疾病认知。本研究探讨了疾病认知是否与CRPS患者的疼痛强度及其他相关结果有关。

方法

在这项横断面研究中,53名CRPS患者(1型和2型)完成了评估疾病认知、疼痛、残疾和心理因素的问卷。在控制了可能的协变量(包括临床和人口统计学因素、疼痛灾难化和消极情绪)后,使用多元回归分析来确定疾病认知是否与疼痛强度、残疾、抑郁和运动恐惧相关。

结果

消极的疾病认知与更严重的疼痛、残疾和运动恐惧相关,但与抑郁无关。具体而言,将更多症状归因于CRPS(更消极的疾病认同认知)与更高的疼痛强度相关,而报告对CRPS的理解较差(疾病一致性得分较低)与更大的残疾和运动恐惧相关。

结论

具有更消极疾病认知(特别是表明对自身病情理解较差的认知)的CRPS患者也会经历更严重的疼痛、残疾和运动恐惧。未来的研究可以调查改变CRPS患者的疾病认知是否会影响临床结果。

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