The relationship of self-efficacy to catastrophizing and depressive symptoms in community-dwelling older adults with chronic pain: A moderated mediation model.
The relationship of self-efficacy to catastrophizing and depressive symptoms in community-dwelling older adults with chronic pain: A moderated mediation model.
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DOI：
10.1371/journal.pone.0203964
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Tam CWC
中科院分区：
文献类型：
--
作者：
Cheng ST;Leung CMC;Chan KL;Chen PP;Chow YF;Chung JWY;Law ACB;Lee JSW;Leung EMF;Tam CWC
在文献中，自我效能感一直被发现是防止心理痛苦和精神障碍的一个保护因素。然而，在慢性疼痛的背景下，关于自我效能感对抑郁症状的调节作用的研究很少。这项横断面研究的目的是检验疼痛自我效能感是否通过减少感觉疼痛时的灾难程度来减弱疼痛强度和抑郁症状之间的直接关系，以及它们之间的间接关系(缓和调节)。从社会中心招募了664名60-95岁的社区居住的中国老年人，他们报告慢性疼痛至少三个月。他们在个人面对面的访谈中完成了一系列关于慢性疼痛、疼痛自我效能、灾难和抑郁症状的问卷调查。控制了年龄、性别、教育程度、自评健康、慢性病数量、疼痛残疾和疼痛自我效能，疼痛灾变被发现在疼痛强度和抑郁症状之间起部分中介作用。此外，疼痛自我效能感调节了疼痛强度与抑郁症状之间的关系。自我效能感在疼痛强度与灾难之间的关系中也起到了调节作用，并且通过Bootstrap分析证实了调节作用。结果表明，随着自我效能感水平的提高，疼痛强度对抑郁症状的直接效应和通过灾变效应对抑郁症状的间接效应均呈剂量依赖关系减弱。我们的发现表明，疼痛自我效能感是一个重要的保护性因素，通过减弱疼痛强度与灾难性症状和抑郁症状的关系，有助于提高慢性疼痛患者的心理韧性。
Self-efficacy has been consistently found to be a protective factor against psychological distress and disorders in the literature. However, little research is done on the moderating effect of self-efficacy on depressive symptoms in the context of chronic pain. This cross-sectional study aimed to examine if pain self-efficacy attenuated the direct relationship between pain intensity and depressive symptoms, as well as their indirect relationship through reducing the extent of catastrophizing when feeling pain (moderated mediation). 664 community-dwelling Chinese older adults aged 60–95 years who reported chronic pain for at least three months were recruited from social centers. They completed a battery of questionnaires on chronic pain, pain self-efficacy, catastrophizing, and depressive symptoms in individual face-to-face interviews. Controlling for age, gender, education, self-rated health, number of chronic diseases, pain disability, and pain self-efficacy, pain catastrophizing was found to partially mediate the connection between pain intensity and depressive symptoms. Furthermore, the relationship between pain intensity and depressive symptoms was moderated by pain self-efficacy. Self-efficacy was also found to moderate the relationship between pain intensity and catastrophizing and the moderated mediation effect was confirmed using bootstrap analysis. The results suggested that with increasing levels of self-efficacy, pain intensity’s direct effect on depressive symptoms and its indirect effect on depressive symptoms via catastrophizing were both reduced in a dose-dependent manner. Our findings suggest that pain self-efficacy is a significant protective factor that contributes to psychological resilience in chronic pain patients by attenuating the relationship of pain intensity to both catastrophizing and depressive symptoms.
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