The experience of pain severity and pain interference in vulvodynia patients: The role of cognitive-behavioural factors, psychological distress and fatigue
The experience of pain severity and pain interference in vulvodynia patients: The role of cognitive-behavioural factors, psychological distress and fatigue
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DOI：
10.1016/j.jpsychores.2016.12.010
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发表时间：
2017-02-01
影响因子：
4.7
通讯作者：
Chilcot, Joseph
中科院分区：
文献类型：
--
作者：
Chisari, Claudia;Chilcot, Joseph
目的：外阴疼痛是一种以外阴剧烈疼痛为特征的慢性疼痛状态。生物-心理-社会模型揭示了疾病感知、认知-行为变量和心理困扰在解释几种情况下疼痛和残疾经历方面的重要性。这些因素从来没有在外阴疼痛中被集体检查过。方法：这项在线横断面研究从意大利慈善协会(Vulvodiniapuntoinfo.com)招募了335名外阴疼痛患者，他们除了完成医院焦虑和抑郁量表、修订后的疾病感知问卷、Chalder疲劳问卷、认知-行为症状问卷和人口统计学问卷外，还完成了疼痛严重程度和干预措施。结果：控制人口统计学和疾病特征的分层回归模型显示，较低的治疗控制信念、较大的疾病认同感、灾难和心理痛苦是疼痛严重程度的显著预测因素，可解释35%的方差。第二次调整的分级回归模型显示，低治疗控制率、较高的疲劳、痛苦和回避/休息行为是疼痛干预的显著预测因素，可解释48%的变量。结论：痛苦、疾病知觉、疲劳和认知行为因素与外阴疼痛的严重程度和干预有关，强调了在这种情况下采用生物心理社会方法的重要性。未来的研究应该随着时间的推移检查这些因素，为未来量身定做的干预措施的发展提供信息，以帮助支持妇女更好地管理外阴疼痛。(C)2016 Elsevier Inc.保留所有权利。
Objective: Vulvodynia is a chronic pain condition characterised by severe pain affecting the vulva. Biopsychosocial models have revealed the importance of illness perceptions, cognitive-behavioural variables and psychological distress in explaining the experience of pain and disability across several conditions. These factors have never been collectively examined in vulvodynia. We predicted that distress, fatigue, illness perceptions, and cognitive -behavioural factors would be associated with pain severity and interference among women with vulvodynia.Methods: This online cross-sectional study recruited 335 vulvodynia patients from an Italian charity association (Vulvodiniapuntoinfo.com), who completed pain severity and interference measures in addition to the Hospital Anxiety and Depression scale, Revised Illness Perception Questionnaire, Chalder Fatigue Questionnaire, Cognitive -Behavioural Symptom Questionnaire and a demographic questionnaire.Results: Hierarchical regression models controlling for demographic and illness characteristics, revealed that lower treatment control beliefs, greater illness identity, catastrophizing and psychological distress, were significant predictors of pain severity, explaining 35% of the variance. A second adjusted hierarchical regression model revealed that low treatment-control, higher fatigue, distress, and avoidance/resting behaviours were significant predictors of pain interference, explaining 48% of the variance.Conclusion: Distress, illness perceptions, fatigue, and cognitive-behavioural factors are associated with pain severity and interference in patients with vulvodynia, highlighting the importance of adopting a biopsychosocial approach in this setting. Future research should examine these factors over time to inform the development of future tailored interventions to help support women better manage vulvodynia. (C) 2016 Elsevier Inc All rights reserved.