Mitigating the Effect of Pain Severity on Activity and Disability in Patients with Chronic Pain: The Crucial Context of Acceptance

被引:15
作者
Kanzler, Kathryn E. [1 ,2 ]
Pugh, Jacqueline A. [3 ,4 ]
McGeary, Donald D. [1 ,2 ]
Hale, Willie J. [5 ]
Mathias, Charles W. [1 ]
Kilpela, Lisa S. [1 ]
Karns-Wright, Tara E. [1 ]
Robinson, Patricia J. [6 ]
Dixon, Sara A. [7 ]
Bryan, Craig J. [8 ,9 ]
Moring, John C. [3 ]
McCracken, Lance M. [10 ]
机构
[1] Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, 7703 Floyd Curl Dr,Mail Code 7794, San Antonio, TX 78229 USA
[2] Univ Texas Hlth Sci Ctr San Antonio, Dept Family & Community Med, 7703 Floyd Curl Dr,Mail Code 7794, San Antonio, TX 78229 USA
[3] South Texas Vet Hlth Care Syst, San Antonio, TX USA
[4] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA
[5] Univ Texas Hlth Sci Ctr San Antonio, Dept Psychol, San Antonio, TX 78229 USA
[6] Mountainview Consulting Grp, Portland, OR USA
[7] Keesler AFB, 81 DS SGD Orofacial Pain, Biloxi, MS USA
[8] Univ Utah, Natl Ctr Vet Studies, Salt Lake City, UT USA
[9] Univ Utah, Dept Psychol, Salt Lake City, UT 84112 USA
[10] Kings Coll London, Dept Psychol, Inst Psychiat Psychol & Neurosci, London, England
基金
美国国家卫生研究院;
关键词
Chronic Pain; Acceptance; Activity; Disability; Functioning; VALUES-BASED ACTION; CHRONIC MUSCULOSKELETAL PAIN; FEAR-AVOIDANCE MODEL; LOW-BACK-PAIN; COMMITMENT THERAPY; PHYSICAL-ACTIVITY; INTERFERENCE; MINDFULNESS; TRIALS; STATE;
D O I
10.1093/pm/pny197
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Objective. The purpose of this study was to examine the effect of pain severity on activity levels and physical disability in the context of high pain acceptance. We hypothesized that pain acceptance moderates the effect of pain severity on general activity and physical disability, such that at higher levels of acceptance, the deleterious effect of pain is mitigated. Methods. Two hundred seven patients with chronic pain were recruited from three clinics in a large southwestern military treatment facility. Participants completed an anonymous self-report battery of standardized measures, including the Chronic Pain Acceptance Questionnaire, modified Oswestry Disability Index, and Pain Severity and General Activity subscales of the West Haven-Yale Multidimensional Pain Inventory. Results. Chronic pain acceptance was found to significantly moderate relations between pain severity and general activity (b = 0.0061, t(198) = 2.75, P = 0.007, 95% confidence interval [CI] = 0.002 to 0.011) and pain severity and disability (b = 0.036, t(193) = -2.564, P = 0.011, 95% CI = -0.063 to -0.008). In the context of higher acceptance, the negative effect of pain on activity and disability appeared reduced. Conversely, in the context of low acceptance, the effect of pain on disability appeared accentuated at all levels of pain severity. Conclusions. Higher acceptance mitigated both activity level and disability in a military-affiliated clinical sample of patients with chronic pain. Results further establish the role of acceptance in relation to functioning in a unique sample of people with chronic pain. These findings have implications for understanding and enhancing functioning in chronic pain populations.
引用
收藏
页码:1509 / 1518
页数:10
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