Adaptive coping strategies in patients with chronic pain conditions and their interpretation of disease
Adaptive coping strategies in patients with chronic pain conditions and their interpretation of disease
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DOI：
10.1186/1471-2458-10-507
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发表时间：
2010-08-20
影响因子：
4.5
通讯作者：
Heusser, Peter
中科院分区：
文献类型：
--
作者：
Buessing, Arndt;Ostermann, Thomas;Heusser, Peter
背景资料：我们研究了哪些适应性应对策略，涉及“疾病控制点”的概念，与慢性疼痛患者相关，以及它们如何与患者的生活满意度和疾病解释相互关联。方法：在一项多中心横断面匿名调查中，我们招募了579名患有各种慢性疼痛状况的患者（平均年龄54 +/-14岁）。因此，患者依赖于外部强大的来源来控制他们的疾病（即，信任医疗帮助;搜索信息和替代帮助），但也对内部权力和美德（即，积极的态度（Positive Attitudes）。相比之下，作为外部超越来源的“相信神助”和作为内部（认知）策略的“重新评估：疾病是偶然的”被适度评价。回归分析表明，积极态度和较高的年龄是患者生活满意度的显著预测因素，而其他适应性应对策略则无显著影响。虽然自适应应对策略与疾病的负面解释，认知重新评价的态度是显着相关的积极的解释，如价值和challenge.Conclusions：疾病的经验可能会提高强度和深度的生活，因此可以解释之间的关联内部自适应应对策略（特别是重新评价）和疾病的积极解释。恢复对疼痛的自我控制感（从而与情况相一致），以及相信一个人不一定因疾病而残疾，是病人护理的主要任务。在卫生服务研究的背景下，除了有效的疼痛管理，需要一个全面的方法，提高病人的心理和精神健康。
Background: We examined which adaptive coping strategies, referring to the concept of 'locus of disease control', were of relevance for patients with chronic pain conditions, and how they were interconnected with patients' life satisfaction and interpretation of disease.Methods: In a multicenter cross-sectional anonymous survey with the AKU questionnaire, we enrolled 579 patients (mean age 54 +/- 14 years) with various chronic pain conditions.Results: Disease as an adverse interruption of life was the prevalent interpretation of chronic pain conditions. As a consequence, patients relied on external powerful sources to control their disease (i.e., Trust in Medical Help; Search for Information and Alternative Help), but also on internal powers and virtues (i.e., Conscious Way of Living; Positive Attitudes). In contrast, Trust in Divine Help as an external transcendent source and Reappraisal: Illness as Chance as an internal (cognitive) strategy were valued moderately. Regression analyses indicated that Positive Attitudes and higher age were significant predictors of patients' life satisfaction, but none of the other adaptive coping strategies. While the adaptive coping strategies were not associated with negative interpretations of disease, the cognitive reappraisal attitude was of significant relevance for positive interpretations such as value and challenge.Conclusions: The experience of illness may enhance intensity and depth of life, and thus one may explain the association between internal adaptive coping strategies (particularly Reappraisal) and positive interpretations of disease. To restore a sense of self-control over pain (and thus congruence with the situation), and the conviction that one is not necessarily disabled by disease, is a major task in patient care. In the context of health services research, apart from effective pain management, a comprehensive approach is needed which enhances the psycho-spiritual well-being of patients.