Developing a Model of Associations Between Chronic Pain, Depressive Mood, Chronic Fatigue, and Self-Efficacy in People With Spinal Cord Injury
Developing a Model of Associations Between Chronic Pain, Depressive Mood, Chronic Fatigue, and Self-Efficacy in People With Spinal Cord Injury
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DOI：
10.1016/j.jpain.2013.03.002
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发表时间：
2013-09-01
期刊：
影响因子：
4
通讯作者：
Middleton, James
中科院分区：
文献类型：
--
作者：
Craig, Ashley;Tran, Yvonne;Middleton, James
慢性疼痛、慢性疲劳和抑郁情绪是脊髓损伤（SCI）患者的常见症状。本研究的目的是调查这些条件之间的关系，在成年人与SCI。多变量方差分析，权变分析和分层回归被用来确定的关系的性质，以及这种关系的自我效能，一个潜在的中介变量的贡献。居住在社区的70名SCI参与者完成了人口统计学和心理测量指标的评估方案，包括经过验证的疼痛、疲劳、抑郁情绪和自我效能感指标。结果表明，高水平慢性疼痛的参与者临床上有抑郁情绪，困惑，疲劳，焦虑和愤怒，活力低下，自我效能感差。高慢性疼痛的参与者有8倍的抑郁情绪和9倍的慢性疲劳的几率。回归分析显示，慢性疼痛导致抑郁情绪升高，自我效能感介导慢性疼痛对情绪的影响。此外，慢性疼痛和抑郁情绪都被证明是慢性疲劳的独立原因。这些结果的影响，为管理慢性疼痛的成年人与SCI.Perspective：疼痛，消极情绪，疲劳和自我效能感在成年人与SCI之间的关系进行了探讨。结果支持一个模型，提出慢性疼痛降低情绪，这是介导（减少）的自我效能，而疼痛和情绪独立增加慢性疲劳。结果为SCI慢性疼痛的治疗提供了方向。(C)2013年美国疼痛协会American Pain Society
Chronic pain, chronic fatigue, and depressive mood are prevalent conditions in people with spinal cord injury (SCI). The objective of this research was to investigate the relationship between these conditions in adults with SCI. Multivariate analysis of variance, contingency analyses, and hierarchical regression were used to determine the nature of the relationship, as well as the contribution to this relationship of self-efficacy, a potential mediator variable. Seventy participants with SCI living in the community completed an assessment regimen of demographic and psychometric measures, including validated measures of pain, fatigue, depressive mood, and self-efficacy. Results indicated that participants with high levels of chronic pain had clinically elevated depressive mood, confusion, fatigue, anxiety and anger, low vigor, and poor self-efficacy. Participants with high chronic pain had 8 times the odds of having depressive mood and 9 times the odds of having chronic fatigue. Regression analyses revealed that chronic pain contributed significantly to elevated depressive mood and that self-efficacy mediated (cushioned) the impact of chronic pain on mood. Furthermore, both chronic pain and depressive mood were shown to contribute independently to chronic fatigue. Implications of these results for managing chronic pain in adults with SCI are discussed.Perspective: The relationship between pain, negative mood, fatigue, and self-efficacy in adults with SCI was explored. Results support a model that proposes that chronic pain lowers mood, which is mediated (lessened) by self-efficacy, whereas pain and mood independently increase chronic fatigue. Results provide direction for treating chronic pain in SCI. (C) 2013 by the American Pain Society