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首页> 外文学位 >A mixed method investigation of predictors of pain and disability in patients with lumbar spinal stenosis.
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A mixed method investigation of predictors of pain and disability in patients with lumbar spinal stenosis.

机译：腰椎管狭窄症患者疼痛和残疾预测因子的混合方法研究。

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摘要

This study identified characteristics associated with pain and disability in LSS at entry to treatment and factors contributing to long-term reduction of pain and disability. It also revealed how patients with LSS appraise the stressors of pain and disability and use coping resources. This study used qualitative and quantitative methods to address the dearth of research in the LSS literature regarding factors associated with severity of pain and disability upon entry to treatment and the influence of coping resources on post-treatment outcomes. A cohort of 34 patients was evaluated to understand the relative contribution of perceived health, self-efficacy, and social support on the stressors of pain and disability using a combination of bivariate and multivariate regression analyses and patient interviews. Several key findings emerged from this research. First, there was an inverse relationship between perceived physical and mental health and severity of disability upon entry to treatment. In interviews, patients with LSS described a variety of sources contributing to stressors of pain and disability including physical limitations, reduced confidence, lack of control, vulnerability, mental health concerns, reduced social participation, frustrations at needing support, and financial limitations. Better perceived physical health had the greatest contribution to reduced levels of pain and disability post-treatment. In interviews, a variety of behaviors were described that improved coping including a greater understanding of limitations and needs along with beliefs for pushing through and remaining positive. In line with the Stress and Coping Model, patients with stronger coping behaviors and more resources reduced the severity and improved outcomes of pain and disability associated with LSS. There is an increased need for research improving the quality of life in later years particularly when faced with a chronic disabling condition such as LSS. Early identification of those at risk for higher pain and disability as well as support for positive coping behaviors post-treatment can help patients with LSS maintain a higher level of participation in society. The factors uncovered in this study serve to inform translational research, clinical practice, and policy recommendations, which may ultimately add to treatment and resources for reducing pain and disability associated with LSS.
机译：这项研究确定了与LSS入院时的疼痛和残疾相关的特征，以及有助于长期减轻疼痛和残疾的因素。它还揭示了LSS患者如何评估疼痛和残疾的压力源并使用应对资源。这项研究使用定性和定量方法来解决LSS文献中有关疼痛和残疾严重程度与进入治疗时的相关因素以及应对资源对治疗后结局的影响等方面研究不足的问题。评估了34名患者的队列，以结合双变量和多变量回归分析以及患者访谈的方式，了解感知的健康，自我效能和社会支持对疼痛和残疾压力源的相对贡献。这项研究得出了一些关键发现。首先，在接受治疗后，身心健康与残疾严重程度之间存在反比关系。在访谈中，患有LSS的患者描述了导致疼痛和残疾压力源的多种原因，包括身体上的局限性，信心下降，缺乏控制力，脆弱性，心理健康问题，社会参与减少，需要支持的挫败感和财务限制。更好地感知身体健康对减少治疗后的疼痛和残疾水平具有最大的贡献。在访谈中，人们描述了各种行为，这些行为可以改善应对能力，包括对局限性和需求的更好理解以及对坚持和保持积极态度的信念。与压力和应对模型相一致，具有更强应对行为和更多资源的患者降低了与LSS相关的疼痛和残疾的严重程度并改善了预后。尤其是在面对诸如LSS之类的慢性致残疾病时，对改善晚年生活质量的研究的需求日益增长。尽早发现有更高疼痛和残疾风险的人，以及支持治疗后积极应对行为，可以帮助LSS患者保持较高的社会参与度。这项研究中发现的因素可为转化研究，临床实践和政策建议提供参考，最终可能会增加治疗和资源，以减轻与LSS相关的疼痛和残疾。

著录项

  • 作者

    Hammerich, Amy Stone.;

  • 作者单位

    University of Colorado at Denver.;

  • 授予单位 University of Colorado at Denver.;
  • 学科 Psychology Behavioral.;Psychology Clinical.
  • 学位 Ph.D.
  • 年度 2013
  • 页码 237 p.
  • 总页数 237
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 石油、天然气工业;
  • 关键词

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