دوره 34، شماره 413: هفته اول اسفند ماه 1395:1595-1606

الگوی ساختاری روابط بین عوامل آسیب‌زای درد، فاجعه‌آفرینی، ترس و سازگاری با درد در بیماران مبتلا به دردهای مزمن عضلانی- اسکلتی

فضل‌اله میر دریکوند, علیرضا شیرازی تهرانی, محمدعلی سپهوندی

چکیده


مقدمه: امروزه، بهترین مدل ارزیابی و درمان درد مزمن عضلانی- اسکلتی، مدل ترس- اجتناب است که نقش عوامل آسیب‌زای درد (روان‌رنجوری، اجتناب تجربی و عواطف منفی) در آن به خوبی مشخص نشده است. هدف از انجام مطالعه‌ی حاضر، بررسی الگوی ساختاری روابط بین عوامل آسیب‌زای درد، فاجعه‌آفرینی، ترس از درد و سازگاری با درد (شدت و ناتوانی درد) در چارچوب مدل ترس- اجتناب بود.

روش‌ها: 314 بیمار مبتلا به دردهای مزمن عضلانی- اسکلتی به روش نمونه‌گیری در دسترس از بیمارستان‌ها و مطب‌های خصوصی شهر اصفهان در سال 1394 انتخاب شدند. این افراد، با پاسخ دادن به شش پرسش‌نامه‌ی تجدید نظر شده‌ی پنج عاملی NEO (NEO-five factor inventory) فهرست عواطف مثبت و منفی (Positive and ngative affect schedule یا PANAS)، پرسش‌نامه‌ی پذیرش و عمل (Acceptance and action questionnaire)، مقیاس فاجعه‌آفرینی درد (Pain catastrophizing scale)، مقیاس ترس از حرکت تمپا (Tampa scale kinesiophobia یا TSK)، و پرسش‌نامه‌ی درجه‌بندی درد مزمن (Graded chronic pain scale) در پژوهش شرکت کردند. برای تحلیل داده‌ها از آزمون مدل‌سازی معادلات ساختاری استفاده شد.

یافته‌ها: عوامل آسیب‌زای درد بر فاجعه‌آفرینی و فاجعه‌آفرینی بر ترس از درد و ترس از درد بر سازگاری درد اثر مستقیم و معنی‌داری داشت (001/0 > P برای همه‌ی موارد). همچنین، فاجعه‌آفرینی از طریق عوامل آسیب‌زای درد و ترس از درد از طریق فاجعه‌آفرینی درد با سازگاری درد به طور غیر مستقیم ارتباط معنی‌داری داشتند؛ در حالی که رابطه‌ی مستقیم عوامل آسیب‌زای درد و سازگاری درد تأیید نشد.

نتیجه‌گیری: عوامل آسیب‌زای درد، توان پیش‌بینی‌ سازگاری درد را در چارچوب مدل ترس- اجتناب دارد. با کاهش عوامل آسیب‌زای درد، می‌توان شدت و ناتوانی درد بیماران مبتلا به اختلالات عضلانی- اسکلتی را کاهش داد.


واژگان کلیدی


عوامل آسیب‌زای درد؛ فاجعه‌آفرینی؛ ترس از درد؛ سازگاری با درد؛ درد؛ دردهای مزمن عضلانی- اسکلتی

تمام متن:

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مراجع


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