疼痛自我效能对类风湿性关节炎和下腰痛患者的调节适应的影响

Effects of Pain Self-Efficacy on Adjustment in Patients with Rheumatoid Arthritis and Low Back Pain

摘要: 背景和目标：慢性疼痛，持续一个月以上的疼痛，是生活当中最为常见的慢性疾病，而其中最容易发生的就是类风湿性关节炎和骨关节炎这两种。患者长期处于痛苦状态，这会导致身体功能失调，引发多种心理问题。尽管有证据表明疼痛自我效能与慢性疼痛患者在情绪和功能等方面的不良适应存在显著相关，但是1) 研究很少来自于关节炎和下腰痛的样本；2) 不良适应仅局限于情绪，功能和疼痛强度三方面中的一种或两种。本研究填补了这方面的空白。方法：本研究招募了50名类风湿性关节炎患者和50名下腰痛患者；所有被试认真填写了人口学采集表，慢性疼痛评分量表(CPG)，抑郁症流行病学研究中心量表(CES-D)和疼痛自我效能问卷(PSEQ)。结果：T检验结果显示两组被试在功能限制，抑郁情绪和疼痛强度三方面均无显著差异(p > 0.05)；双变量相关显示功能限制，疼痛强度和抑郁情绪与疼痛自我效能呈显著负相关；进一步使用阶层多元回归分析发现：疼痛自我效能能够有效预测类风湿性关节炎和下腰痛患者个体的身体状态。结论：1) 更高的疼痛自我效能意味着更多的身体活动，更少的抑郁情绪以及更弱的疼痛强度；2) 疼痛自我效能是类风湿性关节炎(RA)和下腰痛(LBP)患者功能限制，抑郁情绪和疼痛强度的显著预测因子。

Abstract: Background and Objectives: Chronic pain, pain that lasts for more than a month, is one of the most common chronic diseases in life, and the most common types are rheumatoid arthritis and osteoarthritis. Patients are in a state of chronic pain, which will lead to physical dysfunction, causing a variety of psychological problems. Although there is evidence that pain self-efficacy is significantly related to mood and functional maladjustment in patients with chronic pain, 1) few studies have been conducted from samples of arthritis and low back pain; 2) maladjustment is only limited to one or two of the three aspects of emotion, function and pain. This study fills in these gaps. Method: This study recruited 50 patients with rheumatoid arthritis and 50 patients with low back pain. All participants carefully completed the demographic collection form, Chronic Pain Grade (CPG), Center for Epidemiologic Studies Depression (CES-D), and Pain Self-Efficacy Questionnaire (PSEQ). Results: The T test results showed there were no significant differences in functional limitations, depression and pain between the two groups (p > 0.05); bivariate correlation showed that functional limitations, pain and depression were significantly negatively correlated with pain self-efficacy; further hierarchical regression analysis was used to find that pain self-efficacy can effectively predict the physical health of patients with rheumatoid arthritis and low back pain. Conclusion: 1) Higher pain self-efficacy means more physical activity, less depression, and weaker pain perception; 2) Pain self-efficacy was a significant predictor of adjustment in patients with rheumatoid arthritis (RA) and low back pain (LBP).