Department of Palliative & Supportive Care, Greenwich Hospital, HammondCare, Sydney, Australia.
Sydney Medical School - Northern, University of Sydney, Sydney, NSW, Australia.
Pain Med. 2021 Jun 4;22(6):1345-1352. doi: 10.1093/pm/pnaa414.
Existential and spiritual factors are known to play an important role in how people cope with disability and life-threatening illnesses such as cancer. However, comparatively little is known about the impact of pain on factors such as meaning and purpose in one's life and their potential roles in coping with pain.
The aim of this study was to determine spiritual well-being scores in people with persistent pain and to compare these with people with cancer and healthy controls.
We assessed 132 people with chronic pain, 74 people with cancer (49 with pain and 25 without pain) and 68 control participants using standardised measures of pain-related variables including pain intensity, physical function, mood and cognitions. Spiritual well-being was also assessed using a validated and widely used questionnaire, the Functional Assessment of Chronic Illness Therapy - Spirituality Scale (FACIT-Sp).
Spiritual well-being scores were significantly lower in people with persistent pain when compared with controls and were no different when compared with people with cancer, including those who had cancer and pain. In addition, low levels of meaning and purpose were significant predictors of depression, anxiety, and stress across all groups.
The findings demonstrate that persistent pain is associated with spiritual distress that is equal to those observed in people who have cancer. Furthermore, those who have higher levels of meaning and purpose are less likely to develop mood dysfunction when experiencing pain, indicating they may have a protective role.
存在主义和精神因素在人们应对残疾和危及生命的疾病（如癌症）方面起着重要作用。然而，人们对疼痛对生活意义和目标等因素的影响以及它们在应对疼痛方面的潜在作用知之甚少。
本研究旨在确定持续性疼痛患者的精神健康评分，并将其与癌症患者和健康对照组进行比较。
我们使用标准化的疼痛相关变量评估了 132 名慢性疼痛患者、74 名癌症患者（49 名有疼痛，25 名无疼痛）和 68 名对照组参与者，包括疼痛强度、身体功能、情绪和认知。我们还使用经过验证和广泛使用的问卷，即慢性疾病治疗的功能评估-精神量表（FACIT-Sp）评估了精神健康状况。
与对照组相比，持续性疼痛患者的精神健康评分显著降低，与癌症患者（包括患有癌症和疼痛的患者）相比则无差异。此外，低水平的意义和目标是所有组中抑郁、焦虑和压力的重要预测因素。
这些发现表明，持续性疼痛与精神困扰有关，与癌症患者观察到的精神困扰相当。此外，那些具有更高水平的意义和目标的人在经历疼痛时不太可能出现情绪功能障碍，这表明它们可能具有保护作用。
