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慢性疼痛患者的生活质量:以疾病和健康为焦点的应对方式作为调节因素。

Quality of life in chronic pain patients: Illness- and wellness-focused coping as moderators.

机构信息

School of Psychology, University of Minho, Braga, Portugal.

Department of Psychology, Portuguese Catholic University, Braga, Portugal.

出版信息

Psych J. 2021 Apr;10(2):283-294. doi: 10.1002/pchj.410. Epub 2020 Dec 30.

Abstract

Chronic pain is a health problem that significantly influences patients' lives, causing functional, social, socioeconomic, and emotional changes that impact quality of life (QoL). The aim of this study was to evaluate which variables (e.g., psychological morbidity, illness representations, pain, and coping) contribute to QoL and to analyse the moderating role of illness- and wellness-focused coping in the relationship between pain interference and Qol, in chronic pain patients. A sociodemographic and clinical questionnaire, the Brief Illness Perception Questionnaire, the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale, the Chronic Pain Coping Inventory, the Short Form Health Survey, and the Brief Pain Inventory were completed by 103 patients with chronic pain. Greater use of wellness-focused coping and being professionally active were associated with better physical QoL. Cognitive representations and illness-focused coping contributed to physical QoL, and psychological morbidity contributed to mental QoL. Illness-focused coping and wellness-focused coping moderated the relationship between pain interference and physical QoL, but not with mental QoL. Since pain interference was positively related to psychological morbidity, and the latter was negatively related to QoL, it is extremely important to evaluate and promote patients' coping strategies that are focused on well-being to improve QoL. Results from this study underline the relevance of a multidisciplinary approach to chronic pain and the need to account for psychological morbidity and coping strategies in intervention programs to promote QoL in chronic pain patients.

摘要

慢性疼痛是一种严重影响患者生活的健康问题,导致功能、社会、社会经济和情感发生变化,从而影响生活质量(QoL)。本研究旨在评估哪些变量(如心理病态、疾病认知、疼痛和应对)有助于生活质量,并分析以疾病为中心和以健康为中心的应对在疼痛干扰与生活质量之间关系中的调节作用,在慢性疼痛患者中。103 名慢性疼痛患者完成了一份社会人口统计学和临床问卷、简短疾病认知问卷、疼痛灾难化量表、医院焦虑和抑郁量表、慢性疼痛应对量表、健康调查简表和简短疼痛量表。更多地使用以健康为中心的应对方式和积极从事专业活动与更好的身体 QoL 相关。认知表现和以疾病为中心的应对方式有助于身体 QoL,而心理病态则有助于心理 QoL。以疾病为中心的应对方式和以健康为中心的应对方式调节了疼痛干扰与身体 QoL 之间的关系,但与心理 QoL 无关。由于疼痛干扰与心理病态呈正相关,而后者与 QoL 呈负相关,因此评估和促进患者以健康为中心的应对策略非常重要,以改善 QoL。本研究结果强调了多学科方法治疗慢性疼痛的相关性,以及在干预计划中考虑心理病态和应对策略以促进慢性疼痛患者的 QoL 的必要性。

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