Nicola Melinda, Correia Helen, Ditchburn Graeme, Drummond Peter D
Discipline of Psychology, College of Science, Health, Engineering, and Education, Murdoch University, Perth, WA, Australia.
Front Pain Res (Lausanne). 2022 Oct 14;3:884335. doi: 10.3389/fpain.2022.884335. eCollection 2022.
To validate an individual's feelings or behaviour is to sanction their thoughts or actions as worthy of social acceptance and support. In contrast, rejection of the individual's communicated experience indicates a denial of social acceptance, representing a potential survival threat. Pain-invalidation, though ill-defined, appears to be a fundamental component of psychosocial stress for people with chronic pain. As such, the aim of this paper was to define pain-validation and outline its importance for those with chronic pain.
The pain-validation construct was defined using themes inherent in the narratives of those with chronic pain, as identified in a previously published systematic search and thematic analysis, together with examination of additional literature on pain-validation in the clinical context.
We present a construct definition, proposing that pain-validation must necessarily include: (i) that the pain experience is true for the individual, (ii) of the individual's expressions of pain, and (iii) of belief and acceptability to the individual experiencing pain. Further, we outline the importance of pain-validation as a protective factor and means of reducing many of the psychosocial stresses of chronic pain; for example, by indicating social support for pain-coping, buffering negative emotions, and re-enforcing unity and shared identity.
The role of pain-validation in the current era of pain management intervention is discussed. Adhering to interventions that involve cognitive and behavioural change is often difficult. Acknowledging and validating the acceptability of the patient's pain experience in the early stages of pain management may, therefore, be a key component of intervention that encourages compliance to the treatment plan and achieving therapeutic goals.
认可一个人的感受或行为意味着认可他们的思想或行为值得社会接受和支持。相反，拒绝接受个人所传达的经历则表明社会不予认可，这可能构成生存威胁。尽管疼痛无效化的定义尚不明确，但它似乎是慢性疼痛患者心理社会压力的一个基本组成部分。因此，本文旨在界定疼痛确认并概述其对慢性疼痛患者的重要性。
疼痛确认这一概念是根据慢性疼痛患者叙述中固有的主题来定义的，这些主题是在之前发表的系统检索和主题分析中确定的，同时还对临床背景下有关疼痛确认的其他文献进行了研究。
我们提出了一个概念定义，认为疼痛确认必然包括：（i）疼痛体验对个体而言是真实的，（ii）认可个体对疼痛的表达，以及（iii）认可疼痛个体的信念和可接受性。此外，我们概述了疼痛确认作为一种保护因素以及减轻慢性疼痛诸多心理社会压力的手段的重要性；例如，通过表明对疼痛应对的社会支持、缓冲负面情绪以及强化团结和共同身份认同。
讨论了疼痛确认在当前疼痛管理干预时代的作用。坚持涉及认知和行为改变的干预措施往往很困难。因此，在疼痛管理的早期阶段承认并确认患者疼痛体验的可接受性，可能是鼓励患者遵守治疗计划并实现治疗目标的干预措施的关键组成部分。
