Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability.
Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability.
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非心脏胸痛患者的疼痛灾难性：与疼痛，焦虑和残疾的关系。
DOI：
10.1097/psy.0b013e3181b49584
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发表时间：
2009-10
影响因子：
3.3
通讯作者：
Johnson P
中科院分区：
文献类型：
--
作者：
Shelby RA;Somers TJ;Keefe FJ;Silva SG;McKee DC;She L;Waters SJ;Varia I;Riordan YB;Knowles VM;Blazing M;Blumenthal JA;Johnson P
本研究调查了97例非心源性胸痛（NCCP）患者的胸痛、焦虑和疼痛灾难性对残疾的贡献。我们还测试了胸痛和焦虑是否通过疼痛灾难化与更大的残疾间接相关。参与者在完成疼痛灾难化、特质焦虑和残疾的测量之前，完成了7天的胸痛日记。线性路径模型分析探讨了胸痛，特质焦虑，灾难化的身体残疾，心理残疾，残疾的工作，家庭和娱乐活动的贡献。路径模型解释了残疾量表的显著变异性（R2= 0.35至0.52）。胸痛和焦虑占疼痛灾难化方差的46%。胸痛（β= 0.18，Sobel检验Z=2.58，p<0.01）和特质焦虑（β= 0.14，Sobel检验Z=2.11，p<0.05）通过疼痛灾难化与身体残疾有显著的间接关系。胸痛通过疼痛灾难化与心理社会残疾表现出显著的间接关系（β= 0.12，Sobel检验Z=1.96，p= 0.05）。在控制了胸痛和焦虑的影响后，疼痛灾难化不再与工作、家庭和娱乐活动中的残疾有关。胸痛和焦虑与更大的残疾直接相关，并通过疼痛灾难化与身体和心理残疾间接相关。努力改善NCCP患者的功能应考虑解决疼痛灾难化。
This study examined the contributions of chest pain, anxiety, and pain catastrophizing to disability in 97 patients with non-cardiac chest pain (NCCP). We also tested whether chest pain and anxiety were indirectly related to greater disability via pain catastrophizing. Participants completed daily diaries measuring chest pain for seven days prior to completing measures of pain catastrophizing, trait anxiety, and disability. Linear path model analyses examined the contributions of chest pain, trait anxiety, and catastrophizing to physical disability, psychosocial disability, and disability in work, home, and recreational activities. Path models accounted for a significant amount of the variability in disability scales (R2=.35 to .52). Chest pain and anxiety accounted for 46% of the variance in pain catastrophizing. Both chest pain (β=.18, Sobel test Z=2.58, p<.01) and trait anxiety (β=.14, Sobel test Z=2.11, p<.05) demonstrated significant indirect relationships with physical disability via pain catastrophizing. Chest pain demonstrated a significant indirect relationship with psychosocial disability via pain catastrophizing (β=.12, Sobel test Z=1.96, p=.05). After controlling for the effects of chest pain and anxiety, pain catastrophizing was no longer related to disability in work, home, and recreational activities. Chest pain and anxiety were directly related to greater disability and indirectly related to physical and psychosocial disability via pain catastrophizing. Efforts to improve functioning in NCCP patients should consider addressing pain catastrophizing.