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慢性下背痛强度和活动干扰:认知性疼痛应对策略的调节作用的每日日记研究。

Intensity of Chronic Low Back Pain and Activity Interference: A Daily Diary Study of the Moderating Role of Cognitive Pain Coping Strategies.

机构信息

Department of Psychology, Stanford University, Stanford, California, USA.

Stanford Medicine, Stanford University, Stanford, California, USA.

出版信息

Pain Med. 2023 Apr 3;24(4):442-450. doi: 10.1093/pm/pnac151.

Abstract

OBJECTIVE

Chronic low back pain (CLBP) has a significant negative impact on daily functioning, particularly for those with challenges coping adaptively with ongoing pain. However, the dynamics of pain coping in daily life remain understudied. Therefore, we examined the extent to which pain intensity interferes with daily activities, and assessed whether pain coping strategies (as assessed using daily diaries) moderated this link.

METHOD

We analyzed diary data from a sample of 84 participants with CLBP who completed daily diaries for up to 30 days rating pain intensity, pain interference with daily activities, and their use of pain coping strategies, including pain rumination (i.e., repetitive thinking about the pain and its causes), reappraisal (i.e., evaluating one's pain less negatively or more positively), and distraction (i.e., diverting attention from the pain). We hypothesized that these coping strategies would moderate the associations between pain and pain interference with daily activities, although in different directions.

RESULTS

Results suggest that pain rumination strengthens the association between pain intensity and pain interference both on the person and day level, while pain reappraisal and distraction weaken this association, at the day and person levels, respectively.

CONCLUSION

Our findings suggest that those who are more preoccupied with their pain and those who are less likely to reappraise their pain have more pain interference with daily activities. These findings build on prior work on pain coping by using daily diaries and highlight two pain coping strategies that have particular relevance for reducing the impact of CLBP in daily life.

摘要

目的

慢性下背痛(CLBP)对日常功能有显著的负面影响,尤其是对那些难以适应持续疼痛的人。然而,日常生活中的疼痛应对动态仍研究不足。因此,我们研究了疼痛强度在多大程度上干扰日常活动,并评估了疼痛应对策略(通过日常日记评估)是否调节了这种关联。

方法

我们分析了 84 名 CLBP 患者的日记数据,这些患者在长达 30 天的时间内完成了每日日记,记录疼痛强度、疼痛对日常活动的干扰以及他们使用的疼痛应对策略,包括疼痛反刍(即反复思考疼痛及其原因)、重新评价(即对疼痛的评价不那么消极或更积极)和分心(即转移对疼痛的注意力)。我们假设这些应对策略会调节疼痛与疼痛对日常活动的干扰之间的关联,但方向不同。

结果

结果表明,在个体和每日水平上,疼痛反刍增强了疼痛强度与疼痛干扰之间的关联,而疼痛重新评价和分心则分别在每日和个体水平上削弱了这种关联。

结论

我们的发现表明,那些更专注于自己疼痛的人和那些不太可能重新评价自己疼痛的人,其日常活动中的疼痛干扰更大。这些发现建立在使用日常日记研究疼痛应对的先前工作基础上,并强调了两种对减轻 CLBP 在日常生活中的影响具有特殊意义的疼痛应对策略。

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