Bean Debbie J, Dryland Amber, Rashid Usman, Tuck Natalie L
Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand; Pain Management Unit, Anaesthesiology & Perioperative Medicine, Waitematā District Health Board, Auckland, New Zealand.
Department of Psychology, Auckland University of Technology, Auckland, New Zealand.
J Pain. 2022 Oct;23(10):1749-1764. doi: 10.1016/j.jpain.2022.05.006. Epub 2022 Jun 11.
People with chronic pain report experiencing stigma, but few studies have explored this in detail. This mixed-methods study aimed to investigate factors that contribute to chronic pain stigma, the effects of stigma, and to explore the stigma experiences of people with chronic pain. Participants were 215 adults with chronic pain who completed questionnaires assessing chronic pain stigma, opioid use, mental health conditions, pain, depression, disability and social support, and 179 also answered open-ended questions about stigma experiences. Linear regression and path analysis showed that greater stigma was experienced by those who used more opioids, had a mental health condition, viewed their pain as organic, and were unemployed. Stigma was associated with greater disability, depression and lower social support. Qualitative results supported quantitative findings, with 3 themes: 1. "Faking It": Others disbelieve pain and attribute it to drug seeking, laziness, or mental health problems, 2. A spectrum of stigma: Experiences of stigma vary from none to widespread, and 3. "I hide it well": Concealing pain and avoiding stigmatizing situations lead to isolation & disability. This study demonstrates the negative influence of stigma and presents a novel integrated model of chronic pain stigma which may be used to develop interventions. PERSPECTIVE: This study demonstrates the contributors to, and negative effects of, stigma for people with chronic pain. It presents an integrated model which could guide strategies to reduce chronic pain stigma amongst health professionals and the public, and to reduce self-stigma amongst people with pain.
患有慢性疼痛的人表示遭受了污名化，但很少有研究对此进行详细探讨。这项混合方法研究旨在调查导致慢性疼痛污名化的因素、污名化的影响，并探索慢性疼痛患者的污名化经历。参与者为215名患有慢性疼痛的成年人，他们完成了评估慢性疼痛污名化、阿片类药物使用、心理健康状况、疼痛、抑郁、残疾和社会支持的问卷，其中179人还回答了关于污名化经历的开放式问题。线性回归和路径分析表明，使用更多阿片类药物、患有心理健康疾病、认为自己的疼痛是器质性的以及失业的人遭受的污名化更严重。污名化与更大程度的残疾、抑郁和更低的社会支持相关。定性结果支持了定量研究结果，有三个主题：1. “假装疼痛”：其他人不相信疼痛，并将其归因于寻求药物、懒惰或心理健康问题；2. 一系列污名化：污名化经历从无到广泛存在；3. “我很好地隐藏了它”：隐藏疼痛并避免污名化的情况会导致孤立和残疾。这项研究证明了污名化的负面影响，并提出了一种新的慢性疼痛污名化综合模型，可用于制定干预措施。观点：这项研究证明了慢性疼痛患者污名化的促成因素及其负面影响。它提出了一个综合模型，可指导在卫生专业人员和公众中减少慢性疼痛污名化以及减少疼痛患者自我污名化的策略。
