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成年癌症患者疼痛灾难化与精神健康的关系:一项横断面观察性研究。

The Relationship Between Pain Catastrophizing and Spiritual Well-Being in Adult Cancer Patients: A Cross-Sectional Observational Study.

作者信息

Lo Cascio Alessio, Napolitano Daniele, Latina Roberto, Dabbene Marcella, Bozzetti Mattia, Sblendorio Elena, Mancin Stefano, Sguanci Marco, Piredda Michela, De Marinis Maria Grazia

机构信息

Department of Biomedicine and Prevention (A.L.C., D.N., M.B., E.S.), University of Rome Tor Vergata, Via Montpellier, Rome, Italy.

Department of Biomedicine and Prevention (A.L.C., D.N., M.B., E.S.), University of Rome Tor Vergata, Via Montpellier, Rome, Italy.

出版信息

J Pain Symptom Manage. 2025 Jul;70(1):30-37. doi: 10.1016/j.jpainsymman.2025.03.035. Epub 2025 Apr 4.

DOI:10.1016/j.jpainsymman.2025.03.035
PMID:40187380
Abstract

CONTEXT

Chronic cancer-related pain adversely affects patients' physical and psychological well-being. Pain catastrophizing intensifies pain perception and emotional distress, whereas spiritual well-being may provide essential coping mechanisms. The interplay between spiritual well-being and pain catastrophizing in cancer patients is not thoroughly studied.

OBJECTIVES

To investigate the relationship between spiritual well-being and pain catastrophizing in cancer patients experiencing chronic pain.

METHODS

A cross-sectional observational study was conducted from June 2023 to June 2024 at cancer center enrolling patients with cancer and pain intensity ≥4/10. Participants completed the Pain Catastrophizing Scale and the FACIT-Spiritual Well-being Scale (FACIT-Sp-12) including the domains Meaning, Peace, Faith. Demographic data, symptom burden, and Karnofsky performance status were also collected. A Generalized Additive Model was employed to assess associations between scores of Pain Catastrophizing Scale and spiritual well-being domains, controlling for symptom burden and demographic variables.

RESULTS

Ninety-seven patients, mostly male, with gastrointestinal cancer, a mean age of 62.9 years and mean Karnofsky score 44.4 (SD 7.7) completed the study. Higher levels of Peace (β = -1.96, p = 0.004) and Faith (β = -0.99, P = 0.031) were significantly associated with lower pain catastrophizing, while meaning was not significantly associated (β = 0.87, P = 0.237). Increased symptom burden was positively correlated with higher pain catastrophizing (β = 0.16, P = 0.005). The model explained 38.9% of the variance in pain catastrophizing scores (Adjusted R² = 0.389).

CONCLUSION

Spiritual well-being, specifically the Peace and Faith domains, is inversely related to pain catastrophizing in cancer patients. Integrating spiritual care into pain management strategies may enhance coping mechanisms and reduce emotional distress, thereby improving patients' quality of life.

摘要

背景

慢性癌症相关疼痛会对患者的身心健康产生不利影响。疼痛灾难化会加剧疼痛感知和情绪困扰,而精神健康可能提供重要的应对机制。癌症患者精神健康与疼痛灾难化之间的相互作用尚未得到充分研究。

目的

探讨慢性疼痛癌症患者精神健康与疼痛灾难化之间的关系。

方法

2023年6月至2024年6月在癌症中心进行了一项横断面观察研究,纳入癌症患者且疼痛强度≥4/10。参与者完成了疼痛灾难化量表和FACIT精神健康量表(FACIT-Sp-12),包括意义、安宁、信念等维度。还收集了人口统计学数据、症状负担和卡诺夫斯基表现状态。采用广义相加模型评估疼痛灾难化量表得分与精神健康维度之间的关联,并控制症状负担和人口统计学变量。

结果

97名患者完成了研究,大多数为男性,患有胃肠道癌症,平均年龄62.9岁,平均卡诺夫斯基评分为44.4(标准差7.7)。较高水平的安宁(β = -1.96,p = 0.004)和信念(β = -0.99,P = 0.031)与较低的疼痛灾难化显著相关,而意义维度则无显著关联(β = 0.87,P = 0.237)。症状负担增加与较高的疼痛灾难化呈正相关(β = 0.16,P = 0.005)。该模型解释了疼痛灾难化得分中38.9%的方差(调整后R² = 0.389)。

结论

精神健康,特别是安宁和信念维度,与癌症患者的疼痛灾难化呈负相关。将精神关怀纳入疼痛管理策略可能会增强应对机制,减少情绪困扰,从而提高患者的生活质量。

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