Functional and Surgical Urology Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy.
Department of Urology, San Donato Hospital, Arezzo, Italy.
Neurourol Urodyn. 2021 Apr;40(4):1011-1020. doi: 10.1002/nau.24659. Epub 2021 Mar 25.
Resilience represents a fundamental element in the experience of pain, as it allows adaptation to suffering and increases psychological social well-being and quality of life (QoL). We investigated resilience in patients affected by urologic chronic pelvic pain (UCPP) and the relationships with pain severity and distribution, catastrophizing and psychological distress.
Forty-eight consecutive UCPP patients were classified on a pain body map as being affected by pelvic pain only or widespread pain (WP), and underwent the evaluation of resilience with the 14-item Resilience Scale (RS-14), with higher scores indicating high resilience levels; scores < 56 denote very poor resilience. Pelvic and nonpelvic pain intensity and the bother of urinary symptoms on QoL were measured by means of Pain Numerical Rating Scale (PNRS) and Visual Analog Scale (VAS). Pain Catastrophizing Scale (PCS) and Depression Anxiety Stress Scales (DASS-21) investigated catastrophizing and psychological conditions.
Overall, RS-14 mean ± SD total score was 50.2 ± 12.5 in patients with pelvic pain only and 40.2 ± 10.2 in those with WP. Significant relationships were observed between low resilience levels and high scores of pelvic and nonpelvic PNRS, VAS, pain catastrophizing scale and depression and anxiety, stress scale (for all: p < 0.001). Significantly lower RS-14 scores were detected in females and in patients with WP.
A very poor resilience has been identified in UCPP patients, particularly in those with greater catastrophizing and mood alterations. WP and female gender were mostly affected. In UCPP patients, low resilience appears as a crucial factor in pain experience.
韧性是疼痛体验中的一个基本要素，因为它允许对痛苦进行适应，并提高心理社会幸福感和生活质量（QoL）。我们研究了患有泌尿科慢性盆腔疼痛（UCPP）的患者的韧性，以及与疼痛严重程度和分布、灾难化和心理困扰的关系。
48 例连续的 UCPP 患者根据疼痛体图分为仅盆腔疼痛或广泛疼痛（WP），并使用 14 项韧性量表（RS-14）评估韧性，得分越高表示韧性水平越高；得分<56 表示韧性非常差。通过疼痛数字评分量表（PNRS）和视觉模拟量表（VAS）测量盆腔和非盆腔疼痛强度以及尿症状对 QoL 的困扰。疼痛灾难化量表（PCS）和抑郁焦虑压力量表（DASS-21）调查了灾难化和心理状况。
总体而言，仅盆腔疼痛患者的 RS-14 平均总分±标准差为 50.2±12.5，而 WP 患者为 40.2±10.2。低韧性水平与盆腔和非盆腔 PNRS、VAS、疼痛灾难化量表以及抑郁和焦虑、压力量表的高分之间存在显著相关性（所有：p<0.001）。在女性和 WP 患者中，RS-14 得分显著较低。
在 UCPP 患者中，尤其是在那些具有更大灾难化和情绪改变的患者中，发现了非常差的韧性。WP 和女性性别受影响最大。在 UCPP 患者中，低韧性似乎是疼痛体验中的一个关键因素。
