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題名 老化態度與臨床慢性疼痛之關係—以「自覺老化-疼痛關聯性」為調節變項
The Relationship between Attitude toward Aging and Clinical Chronic Pain — “Subjective Aging-Pain Connection” as Moderator作者 龍奕薰
Long, Yi-Hsun貢獻者 吳治勳
Wu, Chih-Hsun
龍奕薰
Long, Yi-Hsun關鍵詞 慢性疼痛
老年人
老化態度
疼痛接受度
疼痛自我效能
Chronic pain
Elderly
Attitude toward aging
Pain acceptance
Pain self-efficacy日期 2021 上傳時間 4-Aug-2021 15:38:04 (UTC+8) 摘要 研究背景：慢性疼痛在老年族群中一直是非常普遍的臨床問題。老年慢性疼痛患者除了經驗疼痛之外，也同時在經歷自身逐漸老化的過程。雖疼痛不一定與患者身體上的老化/退化歷程有關，然而在整體社會環境訊息以及其經驗、認知的影響下，患者可能會將其疼痛狀況與老化連結在一起，而當患者主觀上因為慢性疼痛的相關刺激而意識到或認為自己「老了」，則可能促發其老化態度並影響後續的健康/疼痛狀態。本研究試圖探討中/老年慢性疼痛患者在看待其疼痛經驗時，老化態度對其疼痛情形可能之影響，以及「自覺疼痛—老化關聯性」在其中的調節作用，並檢驗年齡效果。研究方法：本研究以北部某醫學中心之慢性疼痛患者為研究對象，利用疼痛評估與基本資料、「自覺疼痛—老化關聯性」題項、台灣老化態度量表（Taiwan Attitude toward Aging Questionnaire）、疼痛接受度量表（Chronic Pain Acceptance Questionnaire-revised）及疼痛自我效能量表（Pain Self-Efficacy Questionnaire）作為測量工具。以路徑分析探討「自覺疼痛—老化關聯性」是否調節老化態度（正/負老化自我覺知）與疼痛程度、疼痛接受度（活動參與、甘願疼痛）、及疼痛自我效能之間的關係。並以65、60、及50歲作為年齡切分點，探索不同年齡層之差異。研究結果：路徑分析之參數預測結果顯示(1)「自覺疼痛—老化關聯性」低組：負向老化自我覺知可負向預測疼痛自我效能，正向老化自我覺知可正向預測活動參與和疼痛自我效能；(2)「自覺疼痛—老化關聯性」高組：負向老化自我覺知可負向預測活動參與和疼痛自我效能，正向老化自我覺知可負向預測疼痛程度，並正向預測活動參與和疼痛自我效能。(3)進一步檢驗「自覺疼痛—老化關聯性」在不同年齡層中是否有差異，結果顯示以不同年齡作為切分點時，各組呈現之預測效果不一致。結論與討論：(1)本研究結果支持患者「自覺疼痛—老化關聯性」可調節老化態度對個人疼痛狀態之影響；此題項為一直觀、容易評估之工具，可應用於相關研究及臨床服務。(2)關聯性低時，正向老化自我覺知對於疼痛狀態的預測力較強；關聯性高時，負向老化自我覺知的預測力較強。(3)疼痛程度只有在患者認為疼痛與老化的關聯性高時，可被正向老化自我顯著預測(4)老化態度與疼痛狀態各變項可能有其各自影響的年齡層，然相互關係相當複雜尚無法釐清。未來研究應考慮除了疼痛門診以外更充足、來源更多元的樣本，以及加入更多針對主觀年齡、老化歷程、或情緒等方面的測量變項，以對患者「自覺疼痛—老化關聯性」有更深入的理解。
Background: Chronic pain has always been a common clinical problem in older people. In addition to pain, elderly patients with chronic pain were also experiencing their gradual aging process. Although the pain was not necessarily related to the patient`s physical degeneration process, patients might link their pain with aging under the influence of their own life experiences and social information. When patients subjectively recognized or assumed that they are "old" due to their chronic pain, it might elicit their "self-perception of aging (SPA)" and affect their health or pain subsequently. This study aimed to explore the influence of the SPA on pain in middle-aged and old-aged chronic pain patients and examine if "subjective pain-aging connection" and age could serve as moderators.Methods: Chronic pain patients were recruited from pain clinics in a medical center in northern Taiwan. Participants were asked to fill the pain intensity scale, "Subjective Pain-Aging Connection" item, Taiwan Attitude toward Aging Questionnaire, Chronic Pain Acceptance Questionnaire-revised, Pain Self-Efficacy Questionnaire, and demographic variables. The path analysis model was used to explore whether "subjective pain-aging connection" moderated the relationship between self-perception of aging and pain intensity, pain acceptance, and pain self-efficacy. In addition, we used 65, 60, and 50 as age cut-off points to explore the differences in different age groups.Results: The results of the parameter estimations showed that: (1) in the low "subjective pain-aging connection" group, negative SPA could negatively predict pain self-efficacy, and positive SPA could positively predict activity engagement and pain self-efficacy. (2) In the high "subjective pain-aging connection" group, negative SPA could negatively predict activity engagement and pain self-efficacy. Conversely, positive SPA could negatively predict pain intensity and positively predict activity engagement and pain self-efficacy. (3) The prediction effects presented by the age groups were inconsistent.Discussion and conclusion: The results supported that the "subjective pain-aging connection" could moderate the relations between attitude toward aging and pain. This one-item tool was easy-to-assess and suitable for clinical use and research. The positive SPA has a more substantial predictive power for the pain status when the pain-aging connection is low. On the other hand, when the pain-aging connection is high, the negative self-perception of aging has a stronger predictive power. The pain intensity was an exception, it could be significantly predicted by positive SPA only when the patient`s "subjective pain-aging connection" was high. The relationships between SPAs and pain states were quite complicated in age groups and were hard to clarify. Further research should consider recruiting patients more diversely. In addition, adding more concepts of subjective age, personal experience of aging, or emotions could help to have a better and deeper understanding of the patient`s "subjective pain-aging connection."參考文獻 行政院內政部統計處（2020）：《內政部統計月報》（現住人口按三段、六歲年齡組分）。取自https://www.moi.gov.tw/files/site_stuff/321/1/month/month.html行政院衛生福利部社會及家庭署（2020）：《老人福利法》。取自https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=D0050037呂以榮（2006）。老、中、青三代對老人刻板印象之調查—以臺南市為例。臺灣老人保健學刊，2(2), 90-104。李瓊瑛、鄭夙芬、王靜枝、林芷伊（2008）。機構老人慢性疼痛因應之生活經驗。護理雜誌，55(4)，53-62。吳治勳（2010）。對老的刻板印象、老化自我覺知及最適老化（未出版之博士論文）。國立臺灣大學，台北市。吳治勳、陳慶餘、許志成、吳英璋（2016）。臺灣老化態度量表之編製與心理計量特性。中華心理衛生學刊，29(2), 159-186。Asghari, A., & Nicholas, M. K. (2001). Pain self-efficacy beliefs and pain behaviour. A prospective study. Pain, 94(1), 85-100.Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological review, 84(2), 191.Beecher, H. K. (1956). 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Explanations for an established connection. Developmental Review, 46, 27-43. doi:10.1016/j.dr.2017.08.002 描述 碩士
國立政治大學
心理學系
106752007資料來源 http://thesis.lib.nccu.edu.tw/record/#G0106752007 資料類型 thesis dc.contributor.advisor 吳治勳 zh_TW dc.contributor.advisor Wu, Chih-Hsun en_US dc.contributor.author (Authors) 龍奕薰 zh_TW dc.contributor.author (Authors) Long, Yi-Hsun en_US dc.creator (作者) 龍奕薰 zh_TW dc.creator (作者) Long, Yi-Hsun en_US dc.date (日期) 2021 en_US dc.date.accessioned 4-Aug-2021 15:38:04 (UTC+8) - dc.date.available 4-Aug-2021 15:38:04 (UTC+8) - dc.date.issued (上傳時間) 4-Aug-2021 15:38:04 (UTC+8) - dc.identifier (Other Identifiers) G0106752007 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/136475 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 心理學系 zh_TW dc.description (描述) 106752007 zh_TW dc.description.abstract (摘要) 研究背景：慢性疼痛在老年族群中一直是非常普遍的臨床問題。老年慢性疼痛患者除了經驗疼痛之外，也同時在經歷自身逐漸老化的過程。雖疼痛不一定與患者身體上的老化/退化歷程有關，然而在整體社會環境訊息以及其經驗、認知的影響下，患者可能會將其疼痛狀況與老化連結在一起，而當患者主觀上因為慢性疼痛的相關刺激而意識到或認為自己「老了」，則可能促發其老化態度並影響後續的健康/疼痛狀態。本研究試圖探討中/老年慢性疼痛患者在看待其疼痛經驗時，老化態度對其疼痛情形可能之影響，以及「自覺疼痛—老化關聯性」在其中的調節作用，並檢驗年齡效果。研究方法：本研究以北部某醫學中心之慢性疼痛患者為研究對象，利用疼痛評估與基本資料、「自覺疼痛—老化關聯性」題項、台灣老化態度量表（Taiwan Attitude toward Aging Questionnaire）、疼痛接受度量表（Chronic Pain Acceptance Questionnaire-revised）及疼痛自我效能量表（Pain Self-Efficacy Questionnaire）作為測量工具。以路徑分析探討「自覺疼痛—老化關聯性」是否調節老化態度（正/負老化自我覺知）與疼痛程度、疼痛接受度（活動參與、甘願疼痛）、及疼痛自我效能之間的關係。並以65、60、及50歲作為年齡切分點，探索不同年齡層之差異。研究結果：路徑分析之參數預測結果顯示(1)「自覺疼痛—老化關聯性」低組：負向老化自我覺知可負向預測疼痛自我效能，正向老化自我覺知可正向預測活動參與和疼痛自我效能；(2)「自覺疼痛—老化關聯性」高組：負向老化自我覺知可負向預測活動參與和疼痛自我效能，正向老化自我覺知可負向預測疼痛程度，並正向預測活動參與和疼痛自我效能。(3)進一步檢驗「自覺疼痛—老化關聯性」在不同年齡層中是否有差異，結果顯示以不同年齡作為切分點時，各組呈現之預測效果不一致。結論與討論：(1)本研究結果支持患者「自覺疼痛—老化關聯性」可調節老化態度對個人疼痛狀態之影響；此題項為一直觀、容易評估之工具，可應用於相關研究及臨床服務。(2)關聯性低時，正向老化自我覺知對於疼痛狀態的預測力較強；關聯性高時，負向老化自我覺知的預測力較強。(3)疼痛程度只有在患者認為疼痛與老化的關聯性高時，可被正向老化自我顯著預測(4)老化態度與疼痛狀態各變項可能有其各自影響的年齡層，然相互關係相當複雜尚無法釐清。未來研究應考慮除了疼痛門診以外更充足、來源更多元的樣本，以及加入更多針對主觀年齡、老化歷程、或情緒等方面的測量變項，以對患者「自覺疼痛—老化關聯性」有更深入的理解。 zh_TW dc.description.abstract (摘要) Background: Chronic pain has always been a common clinical problem in older people. In addition to pain, elderly patients with chronic pain were also experiencing their gradual aging process. Although the pain was not necessarily related to the patient`s physical degeneration process, patients might link their pain with aging under the influence of their own life experiences and social information. When patients subjectively recognized or assumed that they are "old" due to their chronic pain, it might elicit their "self-perception of aging (SPA)" and affect their health or pain subsequently. This study aimed to explore the influence of the SPA on pain in middle-aged and old-aged chronic pain patients and examine if "subjective pain-aging connection" and age could serve as moderators.Methods: Chronic pain patients were recruited from pain clinics in a medical center in northern Taiwan. Participants were asked to fill the pain intensity scale, "Subjective Pain-Aging Connection" item, Taiwan Attitude toward Aging Questionnaire, Chronic Pain Acceptance Questionnaire-revised, Pain Self-Efficacy Questionnaire, and demographic variables. The path analysis model was used to explore whether "subjective pain-aging connection" moderated the relationship between self-perception of aging and pain intensity, pain acceptance, and pain self-efficacy. In addition, we used 65, 60, and 50 as age cut-off points to explore the differences in different age groups.Results: The results of the parameter estimations showed that: (1) in the low "subjective pain-aging connection" group, negative SPA could negatively predict pain self-efficacy, and positive SPA could positively predict activity engagement and pain self-efficacy. (2) In the high "subjective pain-aging connection" group, negative SPA could negatively predict activity engagement and pain self-efficacy. Conversely, positive SPA could negatively predict pain intensity and positively predict activity engagement and pain self-efficacy. (3) The prediction effects presented by the age groups were inconsistent.Discussion and conclusion: The results supported that the "subjective pain-aging connection" could moderate the relations between attitude toward aging and pain. This one-item tool was easy-to-assess and suitable for clinical use and research. The positive SPA has a more substantial predictive power for the pain status when the pain-aging connection is low. On the other hand, when the pain-aging connection is high, the negative self-perception of aging has a stronger predictive power. The pain intensity was an exception, it could be significantly predicted by positive SPA only when the patient`s "subjective pain-aging connection" was high. The relationships between SPAs and pain states were quite complicated in age groups and were hard to clarify. Further research should consider recruiting patients more diversely. In addition, adding more concepts of subjective age, personal experience of aging, or emotions could help to have a better and deeper understanding of the patient`s "subjective pain-aging connection." en_US dc.description.tableofcontents 第一章 緒論 1第一節 研究動機與目的 1第二節 文獻回顧 3一、慢性疼痛 3二、老年慢性疼痛患者 7三、自覺疼痛—老化關聯性 8四、老化態度對健康的影響 10五、不同年齡層的老化態度對健康的影響 12第三節 研究假設 14第二章 研究方法 17第一節 研究參與者與研究流程 17第二節 研究工具 18一、疼痛評估與基本資料 18二、自覺疼痛—老化關聯性 18三、台灣老化態度量表 18四、疼痛接受度量表 19五、疼痛自我效能量表 19第三節 資料分析 20一、描述統計與比較分析 20二、路徑分析 20第三章 研究結果 21第一節 老化態度對疼痛狀態之效果檢驗 21一、研究參與者與人口學變項之描述統計 21二、各變項描述統計與相關分析 22三、路徑分析 24第二節 自覺疼痛—老化關聯性之調節效果檢驗 26一、研究參與者與人口學變項之描述統計 26二、各變項描述統計、差異檢定及相關分析 28三、路徑分析 31第三節 探索年齡之調節效果 33一、以65歲作為年齡切分點 33二、以60歲作為年齡切分點 36三、以50歲作為年齡切分點 39第四章 討論 43第一節 主觀認知疼痛與老化的關聯性 43一、老化態度對疼痛狀態的影響 47二、關聯性高/低影響正/負向老化態度之預測力 48第二節 年齡的影響 51一、老化態度對疼痛狀態影響之年齡區間 53二、年齡影響正/負向老化態度之預測力 54三、不認老？老太早？ 54第三節 研究貢獻、限制與未來研究方向 57一、研究貢獻與臨床應用 57二、研究限制與未來方向 58參考文獻 61附錄一 臺灣老化態度量表 67附錄二 疼痛接受度量表 68附錄三 疼痛自我效能量表 69 zh_TW dc.format.extent 3315230 bytes - dc.format.mimetype application/pdf - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0106752007 en_US dc.subject (關鍵詞) 慢性疼痛 zh_TW dc.subject (關鍵詞) 老年人 zh_TW dc.subject (關鍵詞) 老化態度 zh_TW dc.subject (關鍵詞) 疼痛接受度 zh_TW dc.subject (關鍵詞) 疼痛自我效能 zh_TW dc.subject (關鍵詞) Chronic pain en_US dc.subject (關鍵詞) Elderly en_US dc.subject (關鍵詞) Attitude toward aging en_US dc.subject (關鍵詞) Pain acceptance en_US dc.subject (關鍵詞) Pain self-efficacy en_US dc.title (題名) 老化態度與臨床慢性疼痛之關係—以「自覺老化-疼痛關聯性」為調節變項 zh_TW dc.title (題名) The Relationship between Attitude toward Aging and Clinical Chronic Pain — “Subjective Aging-Pain Connection” as Moderator en_US dc.type (資料類型) thesis en_US dc.relation.reference (參考文獻) 行政院內政部統計處（2020）：《內政部統計月報》（現住人口按三段、六歲年齡組分）。取自https://www.moi.gov.tw/files/site_stuff/321/1/month/month.html行政院衛生福利部社會及家庭署（2020）：《老人福利法》。取自https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=D0050037呂以榮（2006）。老、中、青三代對老人刻板印象之調查—以臺南市為例。臺灣老人保健學刊，2(2), 90-104。李瓊瑛、鄭夙芬、王靜枝、林芷伊（2008）。機構老人慢性疼痛因應之生活經驗。護理雜誌，55(4)，53-62。吳治勳（2010）。對老的刻板印象、老化自我覺知及最適老化（未出版之博士論文）。國立臺灣大學，台北市。吳治勳、陳慶餘、許志成、吳英璋（2016）。臺灣老化態度量表之編製與心理計量特性。中華心理衛生學刊，29(2), 159-186。Asghari, A., & Nicholas, M. 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