The Impact of Perceived Injustice on Pain-related Outcomes: A Combined Model Examining the Mediating Roles of Pain Acceptance and Anger in a Chronic Pain Sample
The Impact of Perceived Injustice on Pain-related Outcomes: A Combined Model Examining the Mediating Roles of Pain Acceptance and Anger in a Chronic Pain Sample
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DOI：
10.1097/ajp.0000000000000602
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发表时间：
2018-08-01
影响因子：
2.9
通讯作者：
Darnall, Beth D.
中科院分区：
文献类型：
--
作者：
Carriere, Junie S.;Sturgeon, John A.;Darnall, Beth D.
目的：感知不公正（PI）已被确定为疼痛相关结果的一个重要危险因素。迄今为止，研究表明，疼痛接受和愤怒是PI和疼痛相关结果之间关联的中介。然而，目前缺乏一个综合的概念模型来处理这些变量之间的相互关系。因此，目前的研究旨在探讨潜在的中介作用的疼痛接受和愤怒的PI和不良疼痛相关的结果（身体功能，疼痛强度，阿片类药物的使用状态）之间的关联。材料和方法：本横断面研究采用了一个样本的354例慢性疼痛正在接受治疗的三级疼痛治疗中心。参与者完成了PI，疼痛接受，愤怒，身体功能，疼痛强度和阿片类药物使用状态的测量。中介分析被用来研究疼痛接受和愤怒的影响PI和疼痛相关outcomes.Results之间的关联：具体的间接影响的检查显示，疼痛接受完全介导PI和身体功能之间的关系，以及PI和阿片类药物使用状态之间的关系。疼痛接受出现PI和疼痛intensity.Discussion之间的关系的部分调解人：这是第一个研究提供了一个综合的概念模型，调查疼痛接受和愤怒的调解作用PI和疼痛的结果之间的关系。根据我们的研究结果，与PI相关的低水平疼痛接受可能有助于解释PI和不良疼痛结局之间的关联。临床和理论意义进行了讨论。
Objective:Perceived injustice (PI) has been identified as an important risk factor for pain-related outcomes. To date, research has shown that pain acceptance and anger are mediators of the association between PI and pain-related outcomes. However, a combined conceptual model that addresses the interrelationships between these variables is currently lacking. Therefore, the current study aimed to examine the potential mediating roles of pain acceptance and anger on the association between PI and adverse pain-related outcomes (physical function, pain intensity, opioid use status).Materials and Method:This cross-sectional study used a sample of 354 patients with chronic pain being treated at a tertiary pain treatment center. Participants completed measures of PI, pain acceptance, anger, physical function, pain intensity, and opioid use status. Mediation analyses were used to examine the impact of pain acceptance and anger on the association between PI and pain-related outcomes.Results:Examination of the specific indirect effects revealed that pain acceptance fully mediated the relationship between PI and physical function, as well as the relationship between PI and opioid use status. Pain acceptance emerged as a partial mediator of the relationship between PI and pain intensity.Discussion:This is the first study to provide a combined conceptual model investigating the mediating roles of pain acceptance and anger on the relationship between PI and pain outcomes. On the basis of our findings, low levels of pain acceptance associated with PI may help explain the association between PI and adverse pain outcomes. Clinical and theoretical implications are discussed.