心理弹性在强直性脊柱炎患者疼痛与情绪的中介作用
|
摘要
目的:探讨心理弹性在强直性脊柱炎患者疼痛与情绪之间的中介作用。方法:选取太原市某三级甲等医院风湿免疫科192例强直性脊柱炎患者为研究对象,采用患者一般情况问卷、疼痛视觉模拟量表、正负性情绪量表、心理弹性量表进行调查。结果:强直性脊柱炎患者心理弹性为(58.63±13.20)分;正性情绪与心理弹性呈正相关(r=0.68,P<0.01),与总体疼痛程度呈负相关(r=-0.57,P<0.01),与总体疼痛程度呈负相关(r=-0.71,P<0.01)。负性情绪与心理弹性呈负相关(r=-0.42,P<0.01),与总体疼痛程度呈正相关(r=0.48,P<0.01),与夜间疼痛程度呈正相关(r=0.36,P<0.01)。心理弹性与总体疼痛程度和夜间疼痛程度均呈负相关(r=-0.84、-0.64,P<0.01);Bootstrap检验结果显示间接效应的95%CI(0.17,0.40),P<0.001。结论:强直性脊柱炎患者的正负性情绪可通过心理弹性影响疼痛程度,在临床工作中应积极采取有效的干预方法提高患者的心理弹性,从而缓解其疼痛。
Objective:To investigate the mediating effect of mental resilience on pain and emotion in patients with ankylosing spondylitis.Method:A total of 192 patients with ankylosing spondylitis in the Rheumatology and Immunology Department of a class a hospital in Taiyuan City were selected as the research objects,and the general situation questionnaire,visual analogue scale of pain,positive and negative emotion scale and mental resilience scale were used for the investigation.Result:The mental resilience of patients with ankylosing spondylitis was(58.63±13.20)scores.Positive emotions were positively correlated with psychological resilience(r=0.68,P<0.01),negatively correlated with the overall pain level(r=-0.57,P<0.01),and negatively correlated with the overall pain level(r=-0.71,P<0.01).Negative emotions were negatively correlated with psychological resilience(r=-0.42,P<0.01),positively correlated with overall pain level(r=0.48,P<0.01),and positively correlated with night pain level(r=0.36,P<0.01).Mental resilience was negatively correlated with overall pain(r=-0.84,P<0.01)and nighttime pain(r=-0.64,P<0.01).Bootstrap test results showed that 95%CI of indirect effect was(0.17,0.40),P<0.001.Conclusion:The positive and negative emotions of patients with ankylosing spondylitis can affect the degree of pain through mental resilience,and effective intervention methods should be actively adopted in clinical work to improve the psychological resilience of patients,so as to relieve their pain.
Objective:To investigate the mediating effect of mental resilience on pain and emotion in patients with ankylosing spondylitis.Method:A total of 192 patients with ankylosing spondylitis in the Rheumatology and Immunology Department of a class a hospital in Taiyuan City were selected as the research objects,and the general situation questionnaire,visual analogue scale of pain,positive and negative emotion scale and mental resilience scale were used for the investigation.Result:The mental resilience of patients with ankylosing spondylitis was(58.63±13.20)scores.Positive emotions were positively correlated with psychological resilience(r=0.68,P<0.01),negatively correlated with the overall pain level(r=-0.57,P<0.01),and negatively correlated with the overall pain level(r=-0.71,P<0.01).Negative emotions were negatively correlated with psychological resilience(r=-0.42,P<0.01),positively correlated with overall pain level(r=0.48,P<0.01),and positively correlated with night pain level(r=0.36,P<0.01).Mental resilience was negatively correlated with overall pain(r=-0.84,P<0.01)and nighttime pain(r=-0.64,P<0.01).Bootstrap test results showed that 95%CI of indirect effect was(0.17,0.40),P<0.001.Conclusion:The positive and negative emotions of patients with ankylosing spondylitis can affect the degree of pain through mental resilience,and effective intervention methods should be actively adopted in clinical work to improve the psychological resilience of patients,so as to relieve their pain.
引文
[1]Sofia Exarchou,Ulf Lindstr?m,Johan Askling,et al.The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations:a nationwide register study[J].Arthritis Research&Therapy,2015,17(1):118-127.
[2]冀肖健,朱剑,杨金水,等.基于脊柱关节炎智能移动管理系统的队列研究:449例强直性脊柱炎患者基线期临床数据分析[J].中华风湿病学杂志,2016,20(10):669-674.
[3]王笙,曾臻,段振华,等.强直性脊柱炎患者生存质量及影响因素分析[J].中华疾病控制杂志,2013,17(5):384-387.
[4]Ma X H.Clinical application of psychological nursing and healtheducation in patients with ankylosing spondylitis[J].Chinese And Foreign Medical Research,2013,11(30):122-123.
[5]刘延青,崔健君.实用疼痛学[M].北京:人民卫生出版社,2013:104-125.
[6]宋学军.疼痛信号外周神经转导的分子生物学机制[J].中国疼痛医学杂志,2016,22(1):2-7.
[7]宋雨晴,陈红.强直性脊柱炎患者康复护理的研究进展[J].中华护理杂志,2016,10(51):1226-1229.
[8]席居哲,曾也恬,左志宏.中国心理弹性思想探源[J].中国临床心理学杂志,2015,23(3):555-559.
[9]胡燕,刘晓明.强直性脊柱炎患者康复护理分析[J].中国医学创新,2018,15(29):76-78.
[10]张婷,李惠萍,王德斌.心理弹性10年文献回顾及其对心理护理的启示[J].护理学报,2014,21(3):73-75.
[11]Matt B,Bradbury L A.New approaches in ankylosing spondylitis[J].The Medical Journal of Australia,2017,206(5):192-194.
[12]陈睿,唐丹丹,胡理.基于神经生理学的疼痛测量[J].心理科学,2015,38(5):1256-1263.
[13]Tran V.Positive Affect Negative Affect Scale(PANAS)[M].Springer New York,2013.
[14]Stevanovic D,Laurent J,Lakic A.Measuring positive and negative affect and physiological hyperarousalamong Serbian youth[J].Journal of Personality Assessment,2013,95(1):107-117.
[15]Factor structure of the Positive and Negative Affect Schedule(PANAS)in adult women with fibromyalgia from Southern Spain:the al-ándalus project[J].Peer J,2016,4:e1822.
[16]Mealer M,Schmiege S J,Meek P.The Connor-Davidson Resilience Scale in Critical Care Nurses:A Psychometric Analysis[J].Journal of Nursing Measurement,2016,24(1):28-39.
[17]Sharma S,Pathak A,Abbott J H,et al.Measurement properties of the Nepali version of the Connor Davidson resilience scales in individuals with chronic pain[J].Health&Quality of Life Outcomes,2018,16(1):56-66.
[18]温忠麟,叶宝娟.中介效应分析:方法和模型发展[J].心理科学进展,2014,22(5):731-745.
[19]易欣,葛列众,刘宏艳,等.正负性情绪的自主神经反应及应用[J].心理科学进展,2015,23(1):72-84.
[20]Ingrid Brdar.Positive and Negative Affect Schedule(PANAS)[M].Springer New York,2014:227-235.
[21]郑泓,李玲艳,李诗晨,等.中文版正性负性情绪量表在乳腺癌患者中的信度和效度[J].中国临床心理学杂志,2016,24(4):671-674.
[2]冀肖健,朱剑,杨金水,等.基于脊柱关节炎智能移动管理系统的队列研究:449例强直性脊柱炎患者基线期临床数据分析[J].中华风湿病学杂志,2016,20(10):669-674.
[3]王笙,曾臻,段振华,等.强直性脊柱炎患者生存质量及影响因素分析[J].中华疾病控制杂志,2013,17(5):384-387.
[4]Ma X H.Clinical application of psychological nursing and healtheducation in patients with ankylosing spondylitis[J].Chinese And Foreign Medical Research,2013,11(30):122-123.
[5]刘延青,崔健君.实用疼痛学[M].北京:人民卫生出版社,2013:104-125.
[6]宋学军.疼痛信号外周神经转导的分子生物学机制[J].中国疼痛医学杂志,2016,22(1):2-7.
[7]宋雨晴,陈红.强直性脊柱炎患者康复护理的研究进展[J].中华护理杂志,2016,10(51):1226-1229.
[8]席居哲,曾也恬,左志宏.中国心理弹性思想探源[J].中国临床心理学杂志,2015,23(3):555-559.
[9]胡燕,刘晓明.强直性脊柱炎患者康复护理分析[J].中国医学创新,2018,15(29):76-78.
[10]张婷,李惠萍,王德斌.心理弹性10年文献回顾及其对心理护理的启示[J].护理学报,2014,21(3):73-75.
[11]Matt B,Bradbury L A.New approaches in ankylosing spondylitis[J].The Medical Journal of Australia,2017,206(5):192-194.
[12]陈睿,唐丹丹,胡理.基于神经生理学的疼痛测量[J].心理科学,2015,38(5):1256-1263.
[13]Tran V.Positive Affect Negative Affect Scale(PANAS)[M].Springer New York,2013.
[14]Stevanovic D,Laurent J,Lakic A.Measuring positive and negative affect and physiological hyperarousalamong Serbian youth[J].Journal of Personality Assessment,2013,95(1):107-117.
[15]Factor structure of the Positive and Negative Affect Schedule(PANAS)in adult women with fibromyalgia from Southern Spain:the al-ándalus project[J].Peer J,2016,4:e1822.
[16]Mealer M,Schmiege S J,Meek P.The Connor-Davidson Resilience Scale in Critical Care Nurses:A Psychometric Analysis[J].Journal of Nursing Measurement,2016,24(1):28-39.
[17]Sharma S,Pathak A,Abbott J H,et al.Measurement properties of the Nepali version of the Connor Davidson resilience scales in individuals with chronic pain[J].Health&Quality of Life Outcomes,2018,16(1):56-66.
[18]温忠麟,叶宝娟.中介效应分析:方法和模型发展[J].心理科学进展,2014,22(5):731-745.
[19]易欣,葛列众,刘宏艳,等.正负性情绪的自主神经反应及应用[J].心理科学进展,2015,23(1):72-84.
[20]Ingrid Brdar.Positive and Negative Affect Schedule(PANAS)[M].Springer New York,2014:227-235.
[21]郑泓,李玲艳,李诗晨,等.中文版正性负性情绪量表在乳腺癌患者中的信度和效度[J].中国临床心理学杂志,2016,24(4):671-674.