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The relationship between pain beliefs and physical and mental health outcome measures in chronic low back pain: direct and indirect effects

机译：慢性腰痛中疼痛信念与身心健康结局指标之间的关系：直接和间接影响

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Low back pain remains a major health problem with huge societal cost. Biomedical models fail to explain the disability seen in response to reported back pain and therefore patients’ beliefs, cognitions and related behaviours have become a focus for both research and practice. This study used the Pain Beliefs Questionnaire and had two aims: To examine the extent to which pain beliefs are related to disability, anxiety and depression; and to assess whether those relationships are mediated by pain self-efficacy and locus of control. In a sample of 341 chronic low back pain patients, organic and psychological pain beliefs were related to disability, anxiety and depression. However, organicudpain beliefs were more strongly related to disability and depression than psychological pain beliefs. Regression analyses revealed that these relationships were in part independent of pain self-efficacy and locus of control. Further, mediation analyses revealed indirect pathways involving self-efficacyudand, to a lesser extent chance locus of control, between organic pain beliefs, on the one hand, and disability, anxiety and depression, on the other. In contrast, psychological pain beliefs were only directly related to disability, anxiety and depression. Although longitudinal data are needed to corroborate our findings, this study illustrates the importance of beliefs about the nature of pain and beliefs in one’s ability to cope with pain in determining both physical and mental health outcomes in chronic low back pain patients.
机译：腰痛仍然是一个重大的健康问题，需要付出巨大的社会代价。生物医学模型无法解释因报告的背痛而导致的残疾，因此患者的信念，认知和相关行为已成为研究和实践的重点。这项研究使用了《疼痛信念问卷》，目的有两个：检查疼痛信念与残疾，焦虑和抑郁相关的程度；并评估这些关系是否由疼痛的自我效能和控制源所介导。在341名慢性下腰痛患者的样本中，器质性和心理性疼痛观念与残疾，焦虑和抑郁有关。然而，与心理疼痛信念相比，器质性/ udpain信念与残疾和抑郁的关系更为密切。回归分析显示，这些关系部分与疼痛的自我效能和控制源无关。此外，调解分析揭示了间接途径，涉及自我效能感，一方面是器质性疼痛信念之间，另一方面是残疾，焦虑和抑郁，涉及自我效能感的控制源。相反，心理疼痛信念仅与残疾，焦虑和抑郁直接相关。尽管需要纵向数据来证实我们的发现，但这项研究表明，对于慢性下腰痛患者，在确定生理和心理健康结局方面，对疼痛性质的信念和应对疼痛能力的信念至关重要。

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