Department Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, USA.
Scand J Pain. 2023 Mar 20;23(3):531-538. doi: 10.1515/sjpain-2022-0099. Print 2023 Jul 26.
Self-affirmation may be a promising treatment strategy for improving clinical outcomes. This study examined the association between self-affirmation and self-reported health status among people with chronic pain.
In this cross-sectional study, 768 treatment seeking people (female 67.2%, mean age=50.4 years with SD of 17.1, White/Caucasian 59.9%) completed surveys using a learning healthcare system. Measures included spontaneous self-affirmation (SSA) items, PROMIS outcome measures, and Pain Catastrophizing Scale (PCS). Multiple regressions were conducted to examine if strength-based SSA, value-based SSA, and their interaction would predict perceived health status and pain coping strategy. Sensitivity analysis was done by performing additional regressions with covariates (age, sex, race/ethnicity, and education). Lastly, exploratory analysis examined if average SSA scores would have a linear relationship with perceived health status.
The strength x value-based SSA interaction significantly predicted the PROMIS-depression, anxiety, and social isolation T-scores (≤0.007), but not anger T-scores (p=0.067). Specifically, greater tendency to use both SSA styles predicted less symptoms of depression, anxiety and social isolation. This interaction remained significant when controlling for the covariates. The two SSA styles and their interaction did not significantly predict pain interference, sleep disturbance, fatigue, average pain rating and PCS scores (s≥0.054). Exploratory analysis revealed SSA average scores did not have a significant linear relationship with perceived health status.
The current study showed self-affirmation as being associated with better psychosocial health, but not associated with physical health and pain catastrophizing among patients with chronic pain. Our findings suggested the potential benefit of incorporating strength- and value-based affirmations in pain intervention approaches.
自我肯定可能是改善临床结果的一种有前途的治疗策略。本研究调查了自我肯定与慢性疼痛患者自我报告的健康状况之间的关系。
在这项横断面研究中，768 名寻求治疗的患者（女性占 67.2%，平均年龄为 50.4 岁，标准差为 17.1，白种人/高加索人占 59.9%）使用学习型医疗保健系统完成了调查。测量包括自发自我肯定（SSA）项目、PROMIS 结局测量和疼痛灾难化量表（PCS）。进行多元回归分析，以检验基于力量的 SSA、基于价值的 SSA 及其交互作用是否可以预测感知健康状况和疼痛应对策略。通过对协变量（年龄、性别、种族/民族和教育程度）进行额外的回归分析，进行了敏感性分析。最后，探索性分析检查了平均 SSA 分数是否与感知健康状况呈线性关系。
基于力量的 SSA 与基于价值的 SSA 的交互作用显著预测了 PROMIS 抑郁、焦虑和社交孤立 T 分数（≤0.007），但不预测愤怒 T 分数（p=0.067）。具体来说，更倾向于使用两种 SSA 风格预示着抑郁、焦虑和社交孤立症状的减少。当控制协变量时，这种交互作用仍然显著。两种 SSA 风格及其交互作用与疼痛干扰、睡眠障碍、疲劳、平均疼痛评分和 PCS 评分无显著相关性（s≥0.054）。探索性分析显示，SSA 平均分数与感知健康状况无显著线性关系。
本研究表明，自我肯定与慢性疼痛患者的心理社会健康状况相关，但与身体健康和疼痛灾难化无关。我们的研究结果表明，在疼痛干预方法中纳入基于力量和基于价值的肯定可能具有潜在的益处。
