نوع مقاله : مقاله پژوهشی
نویسنده
عضو هیئت علمی گروه روانشناسی دانشگاه شهید چمران اهواز،اهواز ، ایران
چکیده
اصطلاح درد مزمن معمولاً برای توصیف دردی غیرسرطانی و مقاوم به درمان به کار می‌رود که علی‌رغم درمانهای انجام شده بیش از شش ماه تداوم یافته است.
دردهای مزمن برای بسیاری از بیماران مشکلاتی ایجاد می‌کند که از میان آنها می‌توان افسردگی، اضطراب، کاهش کار و فعالیتهای روزمره، ناتوانی جسمانی و مراجعه مکرر به مراکز درمانی را ذکر کرد. اما بررسیهای انجام شده نشان داده است که همه افراد دارای درد مزمن به این گونه مشکلات مبتلا نیستند. با توجه به اینکه درد مزمن همواره با اختلال در سازگاری همراه نیست تعیین عوامل مؤثر بر میزان سازگاری با درد می‌تواند امکان طراحی روشهای کارآمدی را فراهم آورد تا به کمک آنها بتوان به افرادی که دارای سازگاری نامطلوبی با درد مزمن هستند و یا در معرض خطر ناسازگاری هژستند کمک کرد.
در پژوهش حاضر 145 بیمار دارای درد مزمن به مدت 9 ماه مورد مطالعه قرار گرفتند. در ابتدای مطالعه (خط پایه) متغیرهای روان نژندگرایی، شدت درد، خودکفایی مربوط به درد، میزان کنترل بر درد، باور به پایداری درد و راهبرد مقابله‌ای فاجعه آفرینی به عنوان متغیرهای پیش بینی کننده سازگاری با درد و افسردگی، ناتوانی جسمانی، رفتارهای شکایت از درد و میزان مصرف دارو به عنوان متغیرهای ارزیابی کننده میزان سازگاری با درد مورد سنجش قرار گرفتند. متغیرهای اخیر به مدت 9 ماه، هر سه ماه یکبار، اندازه‌گیری شدند.
داده‌های مطالعه با استفاده از روش تحلیل رگرسیون چند متغیری سلسله مراتبی مورد بررسی قرار گرفتند. نتایج این تحلیلها نشان داد که پس از کنترل اثرات سن، جنسیت، سابقه درد و شدت درد، روان‌نژندگرایی می‌تواند شدت افسردگی و شکایت از درد را در طول 9 ماه پیش‌بینی کند. پس از کنترل اثر روان‌نژندگرایی، بیمارانی که در ابتدای مطالعه میزان خودکفایی بالاتری را در مورد درد خود گزارش کرده بودند در طول مطالعه افسردگی، ناتوانی جسمانی و رفتارهای شکایت از درد کمتری را گزارش کرده بودند. آن گروه از بیمارانی که در ابتدای مطالعه از راهبرد مقابله‌ای فاجعه‌آفرینی به هنگام مواجهه با درد بیشتر استفاده می‌کردند در فاصله 3 ماه پس از آغاز مطالعه افسردگی شدیدتری را گزارش کردند. بالاخره بیمارانی که در ابتدای مطالعه میزان کنترل بیشتری را بر درد خود گزارش کرده بودند در فاصله 3 ماه و 6 ماه از آغاز مطالعه مصرف داروی کمتری را گزارش کرده بودند. در این نوشتار یافته‌های فوق و کاربردهای بالینی احتمالی آنها مورد بررسی قرار خواهند گرفت.
کلیدواژه‌ها
عنوان مقاله [English]
The Cross-sectional and Longitudinal Effects of the Personality Dimension of Neuroticism and Pain- Related Beliefs/Coping Strategies on Depression, Physical Disability, Complaint Behaviours and Medication Consumption.
نویسنده [English]
- M.A. Asgharimoghaddam
Faculty member of Psychology Department, Shahid Chamran University, Ahvaz, Ahvaz, Iran
چکیده [English]
The present study examined the cross-sectional and longitudinal effects of the personality dimension of neuroticism and pain-related beliefs/coping strategies on depression, physical disability, complaint behaviours and medication consumption in 145 heterogenous chronic pain patients over a 9-month period. The results were analysed using a series of multiple hierarchical regression analyses which incorporate an attempt to achieve a balance for Type I and Type II errors. All of these analyses were controlled for age, gender, pain duration and pain intensity. The results indicated that the baseline measure of neuroticism was predictive of depression and complaint hehaviour nine months after the initial assessment. After controlling for the effects of neuroticism, the baseline measure of pain self-efficacy beliefs were predictive of depression, physical disability and complaint behaviour nine months after the initial assessment, After controlling for the effects of neuroticism, pain self-efficacy heliefs pain control appraisals and pain stability, the results of the study also support a link between the baseline measure of catastrophising and scores of depression as repoted at the baseline of the study and three months after the initial assessment. Finally, those patients who perceived higher levels of control over the pain at the baseline of the study reported less use of pain-related medication at the 6-month follow-up period. The potential signficance of these findings for identifying patients at risk of poor adjustment to chroi1c pain is discussed.
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