Yale School of Medicine, New Haven, Connecticut.
Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.
Pain Med. 2022 Oct 29;23(11):1820-1827. doi: 10.1093/pm/pnac082.
The Pain and Smoking Inventory (PSI) measures patients' perceived interrelations of their pain and smoking behavior, and it comprises three conceptually distinct domains: smoking to cope with pain (PSI-Cope), pain as a motivator of smoking (PSI-Motivate), and pain as a barrier to cessation (PSI-Barrier). Associations between PSI scores and pain interference and self-efficacy to quit smoking, two measures that can affect cessation outcomes, remain unclear.
We conducted a secondary analysis of baseline data from 371 veterans with chronic pain (88% male, Medianage =60) enrolled in a randomized smoking cessation trial. We used sequential multivariate regression models to examine associations between the three PSI domains and pain interference / self-efficacy.
Of 371 veterans who completed baseline surveys, 88% were male, with a median age of 60 years. PSI-Motivate scores were positively associated with pain interference (beta [B]: 0.18, 95% confidence interval [CI]: 0.02 to 0.34). PSI-Barrier subscores were negatively associated with self-efficacy (B: -0.23, 95% CI: -0.36 to -0.10).
Findings suggest that individuals who hold maladaptive perceptions of pain-smoking interrelations could be more likely to endorse higher pain interference and lower self-efficacy-two established predictors of cessation outcomes. Moreover, each PSI subscale demonstrated unique relationships with the dependent variables, and our results provided support for a three-factor structure. These findings further demonstrate that the PSI comprises three conceptually and empirically distinct domains; future research should evaluate the clinical utility of assessing each domain in relation to cessation outcomes.
疼痛和吸烟量表（PSI）衡量患者对疼痛和吸烟行为的感知相互关系，它包括三个概念上不同的领域：用吸烟来应对疼痛（PSI-Cope）、疼痛是吸烟的动机（PSI-Motivate）和疼痛是戒烟的障碍（PSI-Barrier）。PSI 评分与疼痛干扰和戒烟自我效能之间的关联仍不清楚，这两个因素会影响戒烟的结果。
我们对参加随机戒烟试验的 371 名慢性疼痛退伍军人（88%为男性，中位年龄为 60 岁）的基线数据进行了二次分析。我们使用序贯多元回归模型来检验三个 PSI 领域与疼痛干扰/戒烟自我效能之间的关联。
在完成基线调查的 371 名退伍军人中，88%为男性，中位年龄为 60 岁。PSI-Motivate 得分与疼痛干扰呈正相关（β：0.18，95%置信区间：0.02 至 0.34）。PSI-Barrier 子量表与自我效能呈负相关（B：-0.23，95%置信区间：-0.36 至 -0.10）。
研究结果表明，对疼痛-吸烟相互关系持有不良认知的个体可能更容易出现更高的疼痛干扰和更低的戒烟自我效能，这两个因素是戒烟结果的既定预测因素。此外，PSI 的每个子量表都与因变量存在独特的关系，我们的结果为三因素结构提供了支持。这些发现进一步表明 PSI 由三个概念上和经验上不同的领域组成；未来的研究应该评估评估每个领域与戒烟结果的关系的临床效用。
