Department of Physiotherapy, Faculty of Health Sciences, Universidad de Malaga, Malaga, Spain.
Universidad Gimbernat, Cantabria, Spain.
Eur Spine J. 2021 Jun;30(6):1689-1698. doi: 10.1007/s00586-021-06731-5. Epub 2021 Jan 27.
To evaluate whether a set of pre-accident demographic, accident-related, post-accident treatment and psychosocial factors assessed in people with acute/subacute whiplash-associated disorders (WAD) mediate the association between pain intensity and: (1) pain interference and (2) expectations of recovery, using Bayesian networks (BNs) analyses. This study also explored the potential mediating pathways (if any) between different psychosocial factors.
This was a cross-sectional study conducted on a sample of 173 participants with acute/subacute WAD. Pain intensity, pain interference, pessimism, expectations of recovery, pain catastrophizing, and self-efficacy beliefs were assessed. BN analyses were conducted to analyse the mediating effects of psychological factors on the association between pain intensity and pain-related outcomes.
The results revealed that self-efficacy beliefs partially mediated the association between pain intensity and pain interference. Kinesiophobia partially mediated the association between self-efficacy and pain catastrophizing. Psychological factors did not mediate the association between pain intensity and expectations of recovery.
These results indicate that individuals with acute/subacute WAD may present with lesser pain interference associated with a determined pain intensity value when they show greater self-efficacy beliefs. As the cross-sectional nature of this study limits firm conclusions on the causal impact, researchers are encouraged to investigate the role that patient's self-efficacy beliefs play in the transition to chronic WAD via longitudinal study designs.
使用贝叶斯网络（BN）分析评估一组在急性/亚急性颈痛相关障碍（WAD）患者中评估的事故前人口统计学、事故相关、事故后治疗和心理社会因素是否在疼痛强度与：（1）疼痛干扰和（2）恢复期望之间的关联中起中介作用。本研究还探讨了不同心理社会因素之间潜在的中介途径（如果有的话）。
这是一项横断面研究，对 173 名急性/亚急性 WAD 患者进行了样本测试。评估了疼痛强度、疼痛干扰、悲观情绪、恢复期望、疼痛灾难化和自我效能信念。进行 BN 分析以分析心理因素对疼痛强度与疼痛相关结果之间关联的中介作用。
结果表明，自我效能信念部分中介了疼痛强度与疼痛干扰之间的关联。运动恐惧部分中介了自我效能与疼痛灾难化之间的关联。心理因素并未介导疼痛强度与恢复期望之间的关联。
这些结果表明，急性/亚急性 WAD 患者可能会表现出与特定疼痛强度值相关的较小疼痛干扰，同时表现出更大的自我效能信念。由于该横断面研究的性质限制了对因果影响的确定结论，因此鼓励研究人员通过纵向研究设计研究患者自我效能信念在慢性 WAD 转变中的作用。
