Fehrmann Elisabeth, Fischer-Grote Linda, Kienbacher Thomas, Tuechler Kerstin, Mair Patrick, Ebenbichler Gerold
Department of Psychology, Karl Landsteiner Institute of Outpatient Rehabilitation Research, Vienna, Austria.
Rehab Zentrum Liesing, Karl Landsteiner University of Health Sciences, Krems, Austria.
Front Rehabil Sci. 2022 Oct 31;3:996945. doi: 10.3389/fresc.2022.996945. eCollection 2022.
The Avoidance-Endurance Model distinguishes between subgroups of low back pain (LBP) patients with three maladaptive styles of coping with pain: fear-avoidance (FAR), distress-endurance (DER), eustress-endurance (EER), and one adaptive coping style (AR). This study aimed to compare the quantity of patients' perceived psychosocial stressors and coping resources across these subgroups.
This cross-sectional study was conducted at an outpatient rehabilitation center for patients with chronic musculoskeletal pain. One hundred and thirty-seven patients (69 women/68 men) with chronic LBP were assessed using the following: a demographic checklist, the visual analogue scale, Avoidance-Endurance Questionnaire, Roland-Morris Disability Questionnaire, Pain Disability Index, and 36-Item Short Form. Subsequently, patients participated in semi-structured interviews led by clinical psychologists, which were intended to identify their perception of stressors and coping resources. The quantity of psychosocial stressors and coping resources were analyzed using deductive and inductive content analyses and then compared between subgroups using chi-square-tests.
FARs experienced significantly higher levels of "mental suffering" ( = <0.001) and "other workplace problems" compared to ARs and EERs ( = <0.001). DERs reported significantly higher levels of "mental suffering" ( = <0.001), "job stress" ( = 0.022), and "familial losses" ( = 0.029) compared to ARs, whereas the AR group demonstrated significantly more "coping resources" ( = 0.001) compared to FARs.
AEM-subgroups differed in the quantity of perceived psychosocial stressors and coping resources with AR, who demonstrated a lower risk for pain chronicity and reported the highest quantity of resources. The variability across subgroups may imply differences in patientś needs regarding therapeutic interventions and suggests that a resource-centered approach to cope with stress and pain may be beneficial.
回避 - 耐力模型区分了患有下背痛（LBP）的患者亚组，这些亚组具有三种应对疼痛的适应不良方式：恐惧回避（FAR）、痛苦耐力（DER）、积极应激耐力（EER），以及一种适应性应对方式（AR）。本研究旨在比较这些亚组患者所感知的心理社会应激源和应对资源的数量。
这项横断面研究在一家慢性肌肉骨骼疼痛患者的门诊康复中心进行。对137例慢性下背痛患者（69名女性/68名男性）进行了如下评估：一份人口统计学清单、视觉模拟量表、回避 - 耐力问卷、罗兰 - 莫里斯残疾问卷、疼痛残疾指数和简明健康调查问卷。随后，患者参加了由临床心理学家主持的半结构化访谈，旨在确定他们对应激源和应对资源的感知。使用演绎和归纳性内容分析法分析心理社会应激源和应对资源的数量，然后使用卡方检验在亚组之间进行比较。
与AR组和EER组相比，FAR组经历的“精神痛苦”水平显著更高（= <0.001），“其他工作场所问题”也更严重（= <0.001）。与AR组相比，DER组报告的“精神痛苦”水平显著更高（= <0.001）、“工作压力”（= 0.022）和“家庭损失”（= 0.029）更多，而AR组与FAR组相比，表现出显著更多的“应对资源”（= 0.001）。
AEM亚组在感知的心理社会应激源和应对资源数量上存在差异，AR组慢性疼痛风险较低且报告的资源数量最多。亚组之间的差异可能意味着患者在治疗干预需求方面存在差异，并表明以资源为中心的应对压力和疼痛的方法可能是有益的。
