The fear-avoidance model of chronic pain: Validation and age analysis using structural equation modeling
The fear-avoidance model of chronic pain: Validation and age analysis using structural equation modeling
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DOI：
10.1016/j.pain.2005.11.018
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发表时间：
2006-04-01
期刊：
影响因子：
7.4
通讯作者：
Vowles, KE
中科院分区：
文献类型：
--
作者：
Cook, AJ;Brawer, PA;Vowles, KE
慢性疼痛的认知-行为、恐惧-回避（FA）模型（Vlaeyen JWS，Kole-Snijders AMJ，Boeren RGB，货车Eck H.慢性腰痛中对运动/（再）损伤的恐惧及其与行为表现的关系。Pain 1995 a;62：363-72）已经发现了广泛的经验支持，但是其多变量预测关系尚未得到一致验证。该模型在慢性疼痛患者年龄组中的适用性也没有得到测试。本研究的目的是使用结构方程模型验证预测关系或多变量FA模型，并评估坦帕运动恐惧症量表（TSK）的因子结构、疼痛相关恐惧水平以及FA模型在三个年龄组（年轻（≥ 55岁）成人）中的拟合度。469例慢性疼痛患者的异质性样本提供了灾难性，疼痛相关的恐惧，抑郁，感知残疾和疼痛严重程度的评级。使用验证性的方法，2因素，13项结构的TSK提供了最佳的拟合，是不变的年龄组。老年参与者被发现有较低的TSK恐惧分数比中年参与者的两个因素（FA，伤害）。Vlaeyen JWS，Kole-Snijders AMJ，Boeren RGB，货车Eck H的修改版本（慢性腰痛中对运动/（再）损伤的恐惧及其与行为表现的关系。Pain 1995a;62：363-72.）FA模型提供了与数据的紧密拟合（chi（2）（29）= 42.0 p > 0.05，GF 1 = 0.98，AGF 1 = 0.97，CF 1 = 0.99，RMSEA = 0.031（90%，CI 0.000-0.050），p紧密拟合= 0.95）。多组分析显示，老年人与中年人的结构权重存在显着差异。对于老年慢性疼痛患者，疼痛相关的恐惧更强的中介作用是支持的结果是一致的FA模型的慢性疼痛，同时表明一些重要的年龄组差异，在这个模型和疼痛相关的恐惧水平。建议对多变量模型进行纵向检验。(c)2005年国际疼痛研究协会。Elsevier B. V.出版，保留所有权利。
The cognitive-behavioral, fear-avoidance (FA) model of chronic pain (Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eck H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 1995a;62:363-72) has found broad empirical Support, but its multivariate, predictive relationships have not been uniformly validated. Applicability of the model across age groups of chronic pain patients has also not been tested. Goals of this study were to validate the predictive relationships or the multivariate FA model using Structural equation modeling and to evaluate the factor structure of the Tampa Scale of Kinesiophobia (TSK), levels of pain-related fear, and fit of the FA model across three age groups: young (= 55) adults. A heterogeneous sample of 469 chronic pain patients provided ratings of catastrophizing, pain-related fear, depression, perceived disability, and pain severity. Using a confirmatory approach, a 2-factor, 13-item structure of the TSK provided the best fit and was invariant across age groups. Older participants were found to have lower TSK fear scores than middle-aged participants for both factors (FA, Harm). A modified version of the Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eck H (Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 1995a;62:363-72.) FA model provided a close fit to the data (chi(2) (29) = 42.0 p > 0.05, GF1 = 0.98, AGF1 = 0.97, CF1 = 0.99, RMSEA = 0.031 (90%, CI 0.000-0.050), p close fit = 0.95). Multigroup analyses revealed significant differences in structural weights for older vs. middle-aged participants. For older chronic pain patients, a stronger mediating role for pain-related fear was Supported Results are consistent with a FA model of chronic pain, while indicating some important age group differences in this model and in levels of pain-related fear. Longitudinal testing of the multivariate model is recommended. (c) 2005 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.