Esteve Rosa, Marcos Estefanía, Reyes-Pérez Ángela, López-Martínez Alicia E, Ramírez-Maestre Carmen
Facultad de Psicología y Logopedia, Andalucía Tech, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, 29071 Málaga, Spain.
Int J Environ Res Public Health. 2021 Mar 16;18(6):3054. doi: 10.3390/ijerph18063054.
There is solid evidence of an association between several psychological flexibility processes, particularly pain acceptance, and adaptation to chronic pain. However, there are relatively few studies on the relationship between pain acceptance and opioid misuse in chronic pain patients. Thus, the aim of the present study was to test a hypothetical model in which pain acceptance would regulate pain sensations and pain-related thoughts and emotions, which would be related to opioid misuse. The sample comprised 140 chronic pain patients attending two hospitals. All patients were receiving pharmacological treatment, including opioid analgesics. Structural equation modelling analyses showed a significant association between higher pain acceptance and lower pain intensity and catastrophizing, and lower levels of anxiety and depression. Only higher anxiety and depression were significantly associated with increased opioid misuse. The results suggest that levels of anxiety, depression, and pain acceptance must be assessed before opioids are prescribed. Pain acceptance implies a relationship with internal events that protects against anxiety and depression and thus against opioid misuse. Acceptance and Commitment Therapy appears to be particularly appropriate for these patients.
有确凿证据表明，几种心理灵活性过程，尤其是疼痛接纳，与慢性疼痛的适应之间存在关联。然而，关于慢性疼痛患者疼痛接纳与阿片类药物滥用之间关系的研究相对较少。因此，本研究的目的是检验一个假设模型，即疼痛接纳会调节疼痛感觉以及与疼痛相关的想法和情绪，而这些又与阿片类药物滥用有关。样本包括在两家医院就诊的140名慢性疼痛患者。所有患者都在接受药物治疗，包括阿片类镇痛药。结构方程模型分析表明，较高的疼痛接纳与较低的疼痛强度、灾难化思维以及较低水平的焦虑和抑郁之间存在显著关联。只有较高的焦虑和抑郁与阿片类药物滥用增加显著相关。结果表明，在开阿片类药物之前，必须评估焦虑、抑郁和疼痛接纳水平。疼痛接纳意味着与内部事件存在一种关系，这种关系可预防焦虑和抑郁，从而预防阿片类药物滥用。接纳与承诺疗法似乎对这些患者特别适用。
