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帕金森病患者的疼痛应对策略及其与生活质量的关系:一项横断面研究。

Pain coping strategies and their association with quality of life in people with Parkinson's disease: A cross-sectional study.

机构信息

Department of Neurology, Jena University Hospital, Jena, Germany.

Center for Healthy Aging, Jena University Hospital, Jena, Germany.

出版信息

PLoS One. 2021 Nov 1;16(11):e0257966. doi: 10.1371/journal.pone.0257966. eCollection 2021.

Abstract

OBJECTIVE

To develop multidimensional approaches for pain management, this study aimed to understand how PD patients cope with pain.

DESIGN

Cross-sectional, cohort study.

SETTING

Monocentric, inpatient, university hospital.

PARTICIPANTS

52 patients with Parkinson's disease (without dementia) analysed.

PRIMARY AND SECONDARY OUTCOME MEASURES

Motor function, nonmotor symptoms, health-related quality of life (QoL), and the Coping Strategies Questionnaire were assessed. Elastic net regularization and multivariate analysis of variance (MANOVA) were used to study the association among coping, clinical parameters, and QoL.

RESULTS

Most patients cope with pain through active cognitive (coping self-statements) and active behavioral strategies (increasing pain behaviors and increasing activity level). Active coping was associated with lower pain rating. Regarding QoL domains, active coping was associated with better physical functioning and better energy, whereas passive coping was associated with poorer emotional well-being. However, as demonstrated by MANOVA, the impact of coping factors (active and passive) on the Short Form 36 domains was negligible after correction for age, motor function, and depression.

CONCLUSION

Passive coping strategies are the most likely coping response of those with depressive symptoms, whereas active coping strategies are the most likely coping response to influence physical function. Although coping is associated with pain rating, the extent that pain coping responses can impact on QoL seems to be low.

摘要

目的

为了制定多维的疼痛管理方法,本研究旨在了解帕金森病患者如何应对疼痛。

设计

横断面、队列研究。

地点

单中心、住院、大学医院。

参与者

分析了 52 名帕金森病患者(无痴呆)。

主要和次要结果测量

评估了运动功能、非运动症状、健康相关生活质量(QoL)和应对策略问卷。使用弹性网络正则化和多变量方差分析(MANOVA)来研究应对、临床参数和 QoL 之间的关联。

结果

大多数患者通过积极的认知(应对自我陈述)和积极的行为策略(增加疼痛行为和增加活动水平)来应对疼痛。积极的应对与较低的疼痛评分相关。在 QoL 领域,积极的应对与更好的身体功能和更好的能量相关,而消极的应对与较差的情绪健康相关。然而,正如 MANOVA 所表明的,在考虑年龄、运动功能和抑郁后,应对因素(积极和消极)对健康状况调查问卷短表 36 个领域的影响可以忽略不计。

结论

被动应对策略是那些有抑郁症状的人最有可能的应对反应,而积极的应对策略是最有可能影响身体功能的应对反应。尽管应对与疼痛评分相关,但疼痛应对反应对 QoL 的影响程度似乎较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d64/8559924/e71d4dd8519e/pone.0257966.g001.jpg

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