Landon T Montag, Tim V Salomons, Rosemary Wilson, Scott Duggan, Etienne J Bisson
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Chronic pain requires specialized treatment to address the multitude of factors that contribute to an individual's pain experience, and effectively managing pain requires a biopsychosocial approach to improve patients' QOL.</p><p><strong>Aim: </strong>This study examined adults with chronic pain after a year of specialized treatment to determine the role of cognitive markers (i.e., pain catastrophizing, depression, pain self-efficacy) in predicting changes in QOL.</p><p><strong>Methods: </strong>Patients in an interdisciplinary chronic pain clinic (<i>N</i> = 197) completed measures of pain catastrophizing, depression, pain self-efficacy, and QOL at baseline and 1 year later. Correlations and a moderated mediation were completed to understand the relationships between the variables.</p><p><strong>Results: </strong>Higher baseline pain catastrophizing was significantly associated with increased mental QOL (<i>b</i> = 0.39, 95% confidence interval [CI] 0.141; 0.648) and decreased depression (<i>b</i> = -0.18, 95% CI -0.306; -0.052) over a year. Furthermore, the relationship between baseline pain catastrophizing and the change in depression was moderated by the change in pain self-efficacy (<i>b</i> = -0.10, 95% CI -0.145; -0.043) over a year. Patients with high baseline pain catastrophizing reported decreased depression after a year of treatment, which was associated with greater QOL improvements but only in patients with unchanged or improved pain self-efficacy.</p><p><strong>Conclusions: </strong>Our findings highlight the roles of cognitive and affective factors and their impact on QOL in adults with chronic pain. Understanding the psychological factors that predict increased mental QOL is clinically useful, because medical teams can optimize these positive changes in QOL through psychosocial interventions aimed at improving patients' pain self-efficacy.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2156330"},"PeriodicalIF":2.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980521/pdf/","citationCount":"0","resultStr":"{\"title\":\"Examining the roles of depression, pain catastrophizing, and self-efficacy in quality of life changes following chronic pain treatment.\",\"authors\":\"Landon T Montag, Tim V Salomons, Rosemary Wilson, Scott Duggan, Etienne J Bisson\",\"doi\":\"10.1080/24740527.2022.2156330\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Adults with chronic pain have a lower quality of life (QOL) compared to the general population. Chronic pain requires specialized treatment to address the multitude of factors that contribute to an individual's pain experience, and effectively managing pain requires a biopsychosocial approach to improve patients' QOL.</p><p><strong>Aim: </strong>This study examined adults with chronic pain after a year of specialized treatment to determine the role of cognitive markers (i.e., pain catastrophizing, depression, pain self-efficacy) in predicting changes in QOL.</p><p><strong>Methods: </strong>Patients in an interdisciplinary chronic pain clinic (<i>N</i> = 197) completed measures of pain catastrophizing, depression, pain self-efficacy, and QOL at baseline and 1 year later. Correlations and a moderated mediation were completed to understand the relationships between the variables.</p><p><strong>Results: </strong>Higher baseline pain catastrophizing was significantly associated with increased mental QOL (<i>b</i> = 0.39, 95% confidence interval [CI] 0.141; 0.648) and decreased depression (<i>b</i> = -0.18, 95% CI -0.306; -0.052) over a year. Furthermore, the relationship between baseline pain catastrophizing and the change in depression was moderated by the change in pain self-efficacy (<i>b</i> = -0.10, 95% CI -0.145; -0.043) over a year. Patients with high baseline pain catastrophizing reported decreased depression after a year of treatment, which was associated with greater QOL improvements but only in patients with unchanged or improved pain self-efficacy.</p><p><strong>Conclusions: </strong>Our findings highlight the roles of cognitive and affective factors and their impact on QOL in adults with chronic pain. 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引用次数: 0
摘要
背景:与一般人群相比,患有慢性疼痛的成年人的生活质量(QOL)较低。慢性疼痛需要专门的治疗,以解决导致个体疼痛体验的多种因素,有效地管理疼痛需要生物心理社会方法来改善患者的生活质量。目的:本研究调查了经过一年专门治疗的慢性疼痛成人,以确定认知标记(即疼痛灾难化,抑郁,疼痛自我效能)在预测生活质量变化中的作用。方法:在交叉学科慢性疼痛门诊(N = 197)的患者在基线和1年后完成疼痛灾难、抑郁、疼痛自我效能和生活质量的测量。完成了相关性和有调节的中介,以了解变量之间的关系。结果:基线疼痛灾难化程度越高,心理生活质量越高(b = 0.39, 95%可信区间[CI] 0.141;0.648)和抑郁减少(b = -0.18, 95% CI -0.306;-0.052)。此外,基线疼痛灾难化与抑郁变化之间的关系被疼痛自我效能的变化所缓和(b = -0.10, 95% CI -0.145;-0.043)。高基线疼痛灾难化的患者在治疗一年后报告抑郁减少,这与更大的生活质量改善有关,但仅适用于疼痛自我效能不变或改善的患者。结论:我们的研究结果突出了认知和情感因素在成人慢性疼痛患者生活质量中的作用及其影响。了解预测精神生活质量增加的心理因素在临床上是有用的,因为医疗团队可以通过旨在提高患者疼痛自我效能的社会心理干预来优化这些积极的生活质量变化。
Examining the roles of depression, pain catastrophizing, and self-efficacy in quality of life changes following chronic pain treatment.
Background: Adults with chronic pain have a lower quality of life (QOL) compared to the general population. Chronic pain requires specialized treatment to address the multitude of factors that contribute to an individual's pain experience, and effectively managing pain requires a biopsychosocial approach to improve patients' QOL.
Aim: This study examined adults with chronic pain after a year of specialized treatment to determine the role of cognitive markers (i.e., pain catastrophizing, depression, pain self-efficacy) in predicting changes in QOL.
Methods: Patients in an interdisciplinary chronic pain clinic (N = 197) completed measures of pain catastrophizing, depression, pain self-efficacy, and QOL at baseline and 1 year later. Correlations and a moderated mediation were completed to understand the relationships between the variables.
Results: Higher baseline pain catastrophizing was significantly associated with increased mental QOL (b = 0.39, 95% confidence interval [CI] 0.141; 0.648) and decreased depression (b = -0.18, 95% CI -0.306; -0.052) over a year. Furthermore, the relationship between baseline pain catastrophizing and the change in depression was moderated by the change in pain self-efficacy (b = -0.10, 95% CI -0.145; -0.043) over a year. Patients with high baseline pain catastrophizing reported decreased depression after a year of treatment, which was associated with greater QOL improvements but only in patients with unchanged or improved pain self-efficacy.
Conclusions: Our findings highlight the roles of cognitive and affective factors and their impact on QOL in adults with chronic pain. Understanding the psychological factors that predict increased mental QOL is clinically useful, because medical teams can optimize these positive changes in QOL through psychosocial interventions aimed at improving patients' pain self-efficacy.