应对方式和信念对纤维肌痛亚组的功能和心理调整的预测作用。
Coping and Beliefs as Predictors of Functioning and Psychological Adjustment in Fibromyalgia Subgroups.
机构信息
Consorcio Hospitalario Provincial de Castelló, Castelló de la Plana, Spain.
Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain.
出版信息
Pain Res Manag. 2022 Apr 14;2022:1066192. doi: 10.1155/2022/1066192. eCollection 2022.
OBJECTIVES
Research has pointed to two profiles of persons with fibromyalgia according to differences in functionality, thus distinguishing between functional and dysfunctional patients. The role of psychological factors underlying such clusters is unclear. This study aims to explore the contribution of pain beliefs and coping on fibromyalgia clustering.
METHODS
A cluster analysis was performed to classify 238 women with fibromyalgia using the Fibromyalgia Impact Questionnaire and the Beck Depression Inventory as clustering variables. Cluster differences in physical functioning, depression, pain beliefs, coping, and age were then calculated (Student's -test). Finally, a binary logistic regression was conducted to study the unique contribution of age, beliefs, and coping on cluster classification.
RESULTS
Two clusters were revealed. Cluster 1 had a poor adaptation to fibromyalgia regarding physical functioning and depression. They generally embraced less adaptive beliefs (i.e., disability, harm, emotion, and requests) and coping strategies (i.e., guarding, resting, and asking for assistance). Cluster 2 showed a better adaptation to fibromyalgia and adopted more favorable beliefs (i.e., control) and coping strategies (i.e., exercise and task persistence). Cluster differences in age were significant but small. The backward binary logistic regression suggested a final model with six predictors (guarding, task persistence, harm, emotion, solicitude, and age) that explained 31% of the variance of group membership. . These results suggest that only a subset of psychological variables uniquely and independently contribute to functional/dysfunctional group membership. The results support the need to address psychological components in the management of fibromyalgia and point to a subset of preferred target beliefs and coping strategies.
目的
研究指出，根据功能差异，纤维肌痛患者存在两种不同特征，从而将患者分为功能正常和功能失调两类。目前尚不清楚造成这种聚类的心理因素的作用。本研究旨在探讨疼痛信念和应对方式对纤维肌痛聚类的影响。
方法
采用 Fibromyalgia Impact Questionnaire 和 Beck 抑郁量表作为聚类变量，对 238 名纤维肌痛女性患者进行聚类分析。然后计算不同聚类在身体功能、抑郁、疼痛信念、应对方式和年龄方面的差异（Student's t 检验）。最后，进行二元逻辑回归分析，以研究年龄、信念和应对方式对聚类分类的独特贡献。
结果
共发现 2 个聚类。聚类 1 在身体功能和抑郁方面对纤维肌痛适应不良。他们普遍接受不太适应的信念（即残疾、伤害、情绪和请求）和应对策略（即防护、休息和寻求帮助）。聚类 2 对纤维肌痛的适应较好，采用了更有利的信念（即控制）和应对策略（即锻炼和坚持任务）。聚类在年龄上存在显著差异，但差异较小。反向二元逻辑回归表明，最终模型有 6 个预测因子（防护、坚持任务、伤害、情绪、关心和年龄），可以解释组内成员的 31%的差异。这些结果表明，只有一小部分心理变量可以独立地、独特地预测功能失调/功能正常的分组。结果支持在纤维肌痛管理中解决心理因素的必要性，并指出了一组首选的目标信念和应对策略。
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