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題名 以縱貫資料初探慢性疼痛患者疼痛強度、自我效能、寂寞感、及疼痛接受度之關係
Exploring the Relationship among Pain Intensity, Self-efficacy, Loneliness, and Pain Acceptance in Chronic Pain Patients: A Longitudinal Study
作者 楊皓涵
Yang, Hao-Han
貢獻者 吳治勳
Wu, Chih-Hsun
楊皓涵
Yang, Hao-Han
關鍵詞 疼痛接受度
疼痛自我效能
疼痛強度
寂寞感
負向情緒
pain acceptance
pain self-efficacy
pain intensity
loneliness
negative emotion
日期 2022
上傳時間 1-Aug-2022 18:10:35 (UTC+8)
摘要 研究背景:許多研究指出,疼痛接受度對慢性疼痛患者的身心適應狀態有正向影 響。從反抗疼痛到接納疼痛、與疼痛共處,患者在過程會歷經許多困難,藉由現 象觀察及文獻回顧,本研究歸納出疼痛強度、寂寞感及疼痛自我效能是可能影響 疼痛接受度的因素,並提出一路徑模式。透過臨床追蹤研究,本研究試圖釐清疼 痛強度、寂寞感及疼痛自我效能三者與疼痛接受度的關係。
研究方法:以北部某教學醫學中心之慢性疼痛患者為研究對象,進行追蹤研究,起始點(T0)與追蹤(T1)間隔三個月。以疼痛評估量尺、慢性疼痛接受度量表 8題版(Chronic Pain Acceptance Questionnaire-8)、疼痛自我效能量表(Pain Self- Efficacy Questionnaire)、UCLA寂寞量表3題版(UCLA 3-item Loneliness Scale)、 慢性病負向情緒量表(Negative Emotions due to Chronic Illness Screening Test)作為測量工具,評估疼痛強度、疼痛接受度(包含「活動參與」與「甘願疼痛」兩 個概念)、疼痛自我效能、寂寞感及負向情緒。路徑分析部分,先以描述統計檢視各研究變項,並利用結構方程模型進行分析,檢視所提出模式是否適配,並探討T0疼痛強度、寂寞感、自我效能、疼痛接受度以及T1疼痛強度與負向情緒之關係。
研究結果:共有176位參與者完成起始點(T0)及三個月追蹤(T1)之評估,平均年齡為60.32歲(SD = 13.76),平均疼痛強度為6.00(SD = 2.63),平均持續 時間為96.52個月(SD = 109.65)。結果發現年齡與負向情緒各自和研究變項有顯著相關,故將年齡以共變項加入模式進行控制,負向情緒則分為高、低負向情緒兩組進行多組並行之路徑分析。路徑分析之參數估計結果顯示(1)全樣本之自我效能能夠正向預測活動參與(β = .42, p = .004),寂寞感能夠負向預測活動參 與(β = -.28, p = .004);自我效能能夠完全中介疼痛強度對活動參與之關係(Effect Size(ES)=-.10,p=.010),部分中介寂寞感對活動參與之關係(ES=-.12,p=.004); 活動參與能夠負向預測疼痛強度(β = -.16, p = .027)及負向情緒(β = -.36, p = .004)。(2)高負向情緒組之寂寞感能夠負向預測活動參與(β = -.24, p = .033), 自我效能能夠正向預測活動參與(β = .36, p = .004),並部分中介寂寞感對活動參與之關係(ES = -.12, p = .011)。活動參與能夠負向預測疼痛強度(β = -.22, p = .047)及負向情緒(β = -.33, p = .010)。(3)低負向情緒組之自我效能能夠正向預測活動參與(β= .52, p = .004),並完全中介疼痛強度對活動參與之關係(ES = -.23, p = .004);活動參與能夠負向預測負向情緒(β = -.48, p = .004)。此外,甘願疼痛無法被任何因素預測,亦無法預測疼痛強度與負向情緒。
討論與結論:本研究發現自我效能對於疼痛接受度有正向預測效果,疼痛接受度能夠正向預測疼痛強度與負向情緒。此結果在臨床上有重要的意義,因自我效能在過去研究中被證實能夠透過相關臨床心理介入提升,因此若能夠藉由自我效能之介入提升自我效能,或許能夠改善患者疼痛接受度並緩解疼痛強度與負向情緒狀態。此外,區辨慢性疼痛患者負向情緒狀態亦有重要的臨床意義:高負向情緒的患者,自我效能顯著受到寂寞感之負向影響;低負向情緒之患者,自我效能則顯著受到疼痛強度之負向影響。在進行照顧時,若能夠先評估患者之負向情緒狀態,可以更有效率地提供適合的介入。未來研究若能夠拓展收案場域至社區,進一步探索患者之不同特徵對本模型的影響,並納入生活品質等較整體性適應評估,或許能夠使疼痛接受之概念與模型更加完整,優化疼痛整體性照護。
Background: Many studies have found that pain acceptance positively affects physical and psychological adaptation in chronic pain patients. It is a suffering process, from resisting pain to accepting pain and living with pain for the patients. Through clinical observations and literature review, this study suggested that pain intensity, loneliness, and pain self-efficacy are the factors that may affect pain acceptance. This study proposes a path model to explore the relationships among pain intensity, loneliness, pain self-efficacy, and pain acceptance in a clinical longitudinal study.
Methods: Chronic pain patients were recruited from pain clinics in a medical center in northern Taiwan. Participants were asked to fill the following scales: pain intensity scale, Chronic Pain Acceptance Questionnaire-8, Pain Self-Efficacy Questionnaire, UCLA 3-item Loneliness Scale, and Negative Emotions due to Chronic Illness Screening Test (NECIS) to assess pain intensity, pain acceptance (including “Activity Engagement (AE)” and “Pain Willingness (PW)”), pain self-efficacy, loneliness, and negative emotion, at baseline (T0) and 3-month follow-up (T1). Descriptive and comparative statistics were used to describe the data. Structural equation modeling was used to perform path analysis. To examine the goodness-of-fit of the model and the relationships among pain intensity, loneliness, self-efficacy, pain acceptance, and follow-up pain intensity and negative emotion.
Results: There were 176 participants completed both T0 and T1 evaluations. The mean age of the participants was 60.32 (SD = 13.76), the mean pain intensity was 6.00 (SD = 2.63), and the mean duration was 96.52 months (SD = 109.65). The results showed that age and negative emotions were significantly correlated with other variables. Thus, age was controlled by included as a covariate to the model, and negative emotions were used as a grouping variable to separate high and low negative emotions for a multi-group path analysis. The results of the parameter estimations showed that (1) All participants: self-efficacy can positively predict Activity Engagement(AE) (β = .42, p = .004) of pain acceptance, and loneliness can negatively predict AE (β = -.28, p = .004); self-efficacy fully mediates the relationship between pain intensity and AE (Effect Size (ES) = -.10, p = .010), and partially mediates the relationship between loneliness and AE (ES = -.12, p = .004); AE can negatively predicted pain intensity (β = -.16, p = .027) and negative emotion (β = -.36, p = .004). (2) High negative emotion group: loneliness can negatively predict AE (β = -.24, p = .033), and self-efficacy can positively predict AE (β = .36, p = .004), and partially mediate the relationship between loneliness and AE (ES = -.12, p = .011). AE can negatively predicted pain intensity (β = -.22, p = .047) and negative emotion (β = -.33, p = .010). (3) Self-efficacy in the low negative emotion group can predict AE (β= .52, p = .004), and completely mediate the relationship between pain intensity and AE (ES = -.23, p = .004); AE can negatively predict negative emotion (β = -.48, p = .004). In addition, pain willingness was not predicted by any variables, nor could it predict any pain indicators.
Discussion and conclusion: This study found that self-efficacy positively affects pain acceptance, and pain acceptance can positively predict pain adaptation. This result may provide a clinically significant meaning, as past studies have proven that self-efficacy can be improved through clinical psychological intervention. Therefore, patients` pain acceptance might be improved through self-efficacy intervention. Furthermore, self- efficacy is significantly affected by loneliness in patients with high negative emotions but significantly affected by pain intensity in the low negative emotion group. Thus, interventions can be provided more efficiently if the patient`s negative emotions can be assessed for further care. Finally, to expand the model`s generalizability and further explore the phenomena of pain acceptance, future research should extend the sample
from clinical to the community, explore the influence of patients` different characteristics on this model, and incorporate more holistic adaptation assessments such as quality of life.
參考文獻 Allen, S. F., Gilbody, S., Atkin, K., & van der Feltz-Cornelis, C. (2020). The associations between loneliness, social exclusion and pain in the general population: AN= 502,528 cross-sectional UK Biobank study. Journal of psychiatric research, 130, 68-74. doi: 10.1016/j.jpsychires.2020.06.028
Archer, K. R., Castillo, R. C., Wegener, S. T., Abraham, C. M., & Obremskey, W. T. (2012). Pain and satisfaction in hospitalized trauma patients: the importance of self-efficacy and psychological distress. Journal of Trauma and Acute Care Surgery, 72(4), 1068-1077. doi: 10.1097/TA.0b013e3182452df5
Arnstein, P., Caudill, M., Mandle, C. L., Norris, A., & Beasley, R. (1999). Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain, 80(3), 483-491. doi: 10.1016/S0304- 3959(98)00220-6
Bandura, A. (1994). Self-efficacy. In V. S. Ramachaudran (Ed.), Encyclopedia of human behavior (Vol. 4, pp. 71-81). New York, NY: Academic Press.
Bandura, A., Freeman, W. H., & Lightsey, R. (1999). Self-efficacy: The exercise of control. New York, NY: Worth Publishers
Barlow, J. H., Cullen, L. A., & Rowe, I. (2002). Educational preferences, psychological well-being and self-efficacy among people with rheumatoid arthritis. Patient education and counseling, 46(1), 11-19. doi: 10.1016/S0738- 3991(01)00146-X
Barlow, J. H., Turner, A. P., & Wright, C. C. (2000). A randomized controlled study of the Arthritis Self-Management Programme in the UK. Health education research, 15(6), 665-680. doi: 10.1093/her/15.6.665
Barlow, J. H., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002). Self- management approaches for people with chronic conditions: a review. Patient education and counseling, 48(2), 177-187. doi: 10.1016/S0738-3991(02)00032- 0
Blyth, F. M., March, L. M., Brnabic, A. J., Jorm, L. R., Williamson, M., & Cousins, M. J. (2001). Chronic pain in Australia: a prevalence study. Pain, 89(2-3), 127- 134. doi: 10.1016/S0304-3959(00)00355-9
Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: prevalence, impact on daily life, and
treatment. European journal of pain, 10(4), 287-333. doi: 10.1016/j.ejpain.2005.06.009
Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychology and aging, 21(1), 140. doi: 10.1037/0882- 7974.21.1.140
Costa, L. D. C. M., Maher, C. G., McAuley, J. H., Hancock, M. J., & Smeets, R. J. (2011). Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain. European Journal of Pain, 15(2), 213-219. doi: 10.1016/j.ejpain.2010.06.014
Council, J. R., Ahern, D. K., Follick, M. J., & Kline, C. L. (1988). Expectancies and functional impairment in chronic low back pain. Pain, 33(3), 323-331. doi: 10.1016/0304-3959(88)90291-6
Damush, T. M., Kroenke, K., Bair, M. J., Wu, J., Tu, W., Krebs, E. E., & Poleshuck, E. (2016). Pain self‐management training increases self‐efficacy, self‐ management behaviours and pain and depression outcomes. European Journal of Pain, 20(7), 1070-1078. doi: 10.1002/ejp.830
de Jong-Gierveld, J. (1987). Developing and testing a model of loneliness. Journal of personality and social psychology, 53(1), 119.
de Jong Gierveld, J. (1998). A review of loneliness: concept and definitions, determinants and consequences. Reviews in Clinical Gerontology, 8(1), 73-80. doi: 10.1017/S0959259898008090
DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of internal medicine, 160(14), 2101-2107. doi: 10.1001/archinte.160.14.2101
Dolce, J. J., Doleys, D. M., Raczynski, J. M., Lossie, J., Poole, L., & Smith, M. (1986). The role of self-efficacy expectancies in the prediction of pain tolerance. Pain, 27(2), 261-272. doi: 10.1016/0304-3959(86)90216-2
Emerson, K., Boggero, I., Ostir, G., & Jayawardhana, J. (2018). Pain as a risk factor for loneliness among older adults. Journal of aging and health, 30(9), 1450- 1461. doi: 10.1177/0898264317721348
Feldman, S. I., Downey, G., & Schaffer-Neitz, R. (1999). Pain, negative mood, and perceived support in chronic pain patients: A daily diary study of people with reflex sympathetic dystrophy syndrome. Journal of Consulting and Clinical psychology, 67(5), 776. doi: 10.1037/0022-006X.67.5.776
Fish, R. A., McGuire, B., Hogan, M., Morrison, T. G., & Stewart, I. (2010). Validation of the Chronic Pain Acceptance Questionnaire (CPAQ) in an Internet sample and development and preliminary validation of the CPAQ-
8. Pain, 149(3), 435-443. doi: 10.1016/j.pain.2009.12.016
Garbi, M. D. O. S. S., Hortense, P., Gomez, R. R. F., Silva, T. D. C. R. D., Castanho, A. C. F., & Sousa, F. A. E. F. (2014). Pain intensity, disability and depression in individuals with chronic back pain. Revista latino-americana de enfermagem, 22, 569-575. doi: 10.1590/0104-1169.3492.2453
Hacihasanoğlu, R., Yildirim, A., & Karakurt, P. (2012). Loneliness in elderly individuals, level of dependence in activities of daily living (ADL) and influential factors. Archives of gerontology and geriatrics, 54(1), 61-66. doi: 10.1016/j.archger.2011.03.011
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of behavioral medicine, 40(2), 218-227. doi: 10.1007/s12160-010-9210-8
Hawkley, L. C., Masi, C. M., Berry, J. D., & Cacioppo, J. T. (2006). Loneliness is a unique predictor of age-related differences in systolic blood
pressure. Psychology and aging, 21(1), 152. doi: 10.1037/0882-7974.21.1.152
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 44(1), 1-25. doi: 10.1016/j.brat.2005.06.006
Huang, Y. H., Wu, C. H., Chen, H. J., Cheng, Y. R., Hung, F. C., Leung, K. K., ... & Wu, Y. C. (2018). Quick screening tool for patients with severe negative emotional reactions to chronic illness: psychometric study of the negative emotions due to chronic illness screening test (NECIS). Family practice, 35(1), 34-40. doi: 10.1093/fampra/cmx076
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on aging, 26(6), 655-672. doi: 10.1177/0164027504268574
IASP. (2019). Definitions of Chronic Pain Syndromes. Retrieved from https://www.iasp-pain.org/advocacy/definitions-of-chronic-pain-syndromes/
IASP. (2020). IASP Announces Revised Definition of Pain. Retrieved from
https://www.iasp-pain.org/PublicationsNews/NewsDetail.aspx?ItemNumber=10475
Jaremka, L. M., Andridge, R. R., Fagundes, C. P., Alfano, C. M., Povoski, S. P., Lipari, A. M., ... & Kiecolt-Glaser, J. K. (2014). Pain, depression, and fatigue: loneliness as a longitudinal risk factor. Health Psychology, 33(9), 948. doi: 10.1037/a0034012
Jaremka, L. M., Fagundes, C. P., Glaser, R., Bennett, J. M., Malarkey, W. B., & Kiecolt-Glaser, J. K. (2013). Loneliness predicts pain, depression, and fatigue: understanding the role of immune dysregulation. Psychoneuroendocri- nology, 38(8), 1310-1317. doi: 10.1016/j.psyneuen.2012.11.016
Jensen, M. P., Moore, M. R., Bockow, T. B., Ehde, D. M., & Engel, J. M. (2011). Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: a systematic review. Archives of physical medicine and rehabilitation, 92(1), 146-160. doi: 10.1016/j.apmr.2010.09.021
Jensen, M. P., Turner, J. A., & Romano, J. M. (1991). Self-efficacy and outcome expectancies: relationship to chronic pain coping strategies and adjustment. Pain, 44(3), 263-269. doi: 10.1016/0304-3959(91)90095-F
LaChapelle, D. L., Lavoie, S., & Boudreau, A. (2008). The meaning and process of pain acceptance. Perceptions of women living with arthritis and fibromyalgia. Pain Research and Management, 13(3), 201-210. doi: 10.1155/2008/258542
Lackner, J. M., & Carosella, A. M. (1999). The relative influence of perceived pain control, anxiety, and functional self efficacy on spinal function among patients with chronic low back pain. Spine, 24(21), 2254. doi: 10.1097/00007632- 199911010-00014
Lackner, J. M., Carosella, A. M., & Feuerstein, M. (1996). Pain expectancies, pain, and functional self-efficacy expectancies as determinants of disability in patients with chronic low back disorders. Journal of consulting and clinical psychology, 64(1), 212. doi: 10.1037/0022-006X.64.1.212
Lauder, W., Mummery, K., Jones, M., & Caperchione, C. (2006). A comparison of health behaviours in lonely and non-lonely populations. Psychology, Health & Medicine, 11(2), 233-245. doi: 10.1080/13548500500266607
Litt, M. D. (1988). Self-efficacy and perceived control: cognitive mediators of pain tolerance. Journal of personality and social psychology, 54(1), 149. doi: 10.1037/0022-3514.54.1.149
Loeffler, A., & Steptoe, A. (2021). Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation. Pain, 162(3), 930. doi: 10.1097/j.pain.0000000000002082
Lorig, K., Chastain, R. L., Ung, E., Shoor, S., & Holman, H. R. (1989). Development and evaluation of a scale to measure perceived self‐efficacy in people with arthritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 32(1), 37-44. doi: 10.1002/anr.1780320107
Lorig, K., & Holman, H. (1993). Arthritis self-management studies: a twelve-year review. Health education quarterly, 20(1), 17-28. doi: 10.1177/1090198193020 00104
Kamper, S. J., Apeldoorn, A. T., Chiarotto, A., Smeets, R. J., Ostelo, R. W., Guzman, J., & van Tulder, M. (2015). Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. Bmj,
Keefe, F. J., Caldwell, D. S., Queen, K. T., Gil, K. M., Martinez, S., Crisson, J. E., ... & Nunley, J. (1987). Pain coping strategies in osteoarthritis patients. Journal of consulting and clinical psychology, 55(2), 208. doi: 10.1037/0022- 006X.55.2.208
Kostova, Z., Caiata-Zufferey, M., & Schulz, P. J. (2014a). The impact of social support on the acceptance process among RA patients: a qualitative study. Psychology & health, 29(11), 1283-1302. doi: 10.1080/08870446.2014.925895
Kostova, Z., Caiata-Zufferey, M., & Schulz, P. J. (2014b). The process of acceptance among rheumatoid arthritis patients in Switzerland: a qualitative study. Pain Research and Management, 19(2), 61-68. doi: 10.1155/2014/168472
MacKinnon, D. P. (2012). Introduction to statistical mediation analysis: Routledge
Maguire, R., Hanly, P., & Maguire, P. (2021). Living well with chronic illness: How social support, loneliness and psychological appraisals relate to well-being in a population-based European sample. Journal of health psychology, 26(10), 1494- 1507. Doi: 10.1177/1359105319883923
McCracken, L. M. (1998). Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain, 74(1), 21-27. doi: 10.1016/S0304-3959(97)00146-2
McCracken, L. M. (1999). Behavioral constituents of chronic pain acceptance: Results from factor analysis of the Chronic Pain Acceptance
Questionnaire. Journal of Back and Musculoskeletal Rehabilitation, 13(2-3), 93-100. doi: 10.3233/BMR-1999-132-306
McCracken, L. M. (2005). Social context and acceptance of chronic pain: the role of solicitous and punishing responses. Pain, 113(1-2), 155-159. doi: 10.1016/j. pain.2004.10.004
McCracken, L. M., Carson, J. W., Eccleston, C., & Keefe, F. J. (2004). Acceptance
pain.2004.02.006
McCracken, L. M., & Eccleston, C. (2003). Coping or acceptance: what to do about
chronic pain?. Pain, 105(1-2), 197-204. doi: 10.1016/S0304-3959(03)00202-1
McCracken, L. M., & Eccleston, C. (2005). A prospective study of acceptance of pain and patient functioning with chronic pain. Pain, 118(1-2), 164-169. doi: 10.1016/j.pain.2005.08.015
McCracken, L. M., & Eccleston, C. (2006). A comparison of the relative utility of coping and acceptance-based measures in a sample of chronic pain sufferers.
McCracken, L. M., Spertus, I. L., Janeck, A. S., Sinclair, D., & Wetzel, F. T. (1999). Behavioral dimensions of adjustment in persons with chronic pain: pain-related anxiety and acceptance. Pain, 80(1-2), 283-289. doi: 10.1016/S0304- 3959(98)00219-X
McCracken, L. M., Vowles, K. E., & Eccleston, C. (2004). Acceptance of chronic pain: component analysis and a revised assessment method. Pain, 107(1-2), 159-166. doi: 10.1016/j.pain.2003.10.012
McCracken, L. M., Vowles, K. E., & Eccleston, C. (2005). Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour research and therapy, 43(10), 1335-1346. doi: 10.1016/j.brat.2004.10.003
McGorry, R. W., Webster, B. S., Snook, S. H., Hsiang, S. M. (2000). The relation between pain intensity, disability, and the episodic nature of chronic and recurrent low back pain. Spine, 25: 834–841.
McWilliams, L. A., Cox, B. J., & Enns, M. W. (2003). Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain, 106(1-2), 127-133. doi: 10.1016/S0304-3959(03)00301-4
Means‐Christensen, A. J., Roy‐Byrne, P. P., Sherbourne, C. D., Craske, M. G., & Stein, M. B. (2008). Relationships among pain, anxiety, and depression in primary care. Depression and anxiety, 25(7), 593-600. doi: 10.1002/da.20342
Melzack, R., & Wall, P. D. (1965). Pain mechanisms: a new theory. Science, 150(3699), 971-979.
Meredith, P., Strong, J., & Feeney, J. A. (2006). Adult attachment, anxiety, and pain self-efficacy as predictors of pain intensity and disability. Pain, 123(1-2), 146- 154. doi: 10.1016/j.pain.2006.02.025
Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V., & Ustun, B. (2007). Depression, chronic diseases, and decrements in health: results from the World Health Surveys. The Lancet, 370(9590), 851-858. doi: doi.org/10.1016/S0140- 6736(07)61415-9
National Academies of Sciences, Engineering, and Medicine. (2020). Social isolation and loneliness in older adults: Opportunities for the health care system. Washington, DC: National Academies Press.
Nicassio, P. M., & Wallston, K. A. (1992). Longitudinal relationships among pain, sleep problems, and depression in rheumatoid arthritis. Journal of abnormal psychology, 101(3), 514. doi: 10.1037/0021-843X.101.3.514
Nicholas, M. K. (1989). Self-efficacy and chronic pain. In St Andrews: Annual Conference of British Psychological Society, 1989.
Nicholas, M. K. (2007). The pain self-efficacy questionnaire: taking pain into account. European journal of pain, 11(2), 153-163. doi: 10.1016/j.ejpain.2005.12.008
Nicholas, M. K., & Asghari, A. (2006). Investigating acceptance in adjustment to chronic pain: Is acceptance broader than we thought?. Pain, 124(3), 269-279. doi: 10.1016/j.pain.2006.04.032
Penninx, B. W., Van Tilburg, T., Kriegsman, D. M., Boeke, A. J. P., Deeg, D. J., & Van Eijk, J. T. M. (1999). Social network, social support, and loneliness in older persons with different chronic diseases. Journal of aging and health, 11(2), 151-168. doi: 10.1177/089826439901100202
Risdon, A., Eccleston, C., Crombez, G., & McCracken, L. (2003). How can we learn to live with pain? A Q-methodological analysis of the diverse understandings of acceptance of chronic pain. Social science & medicine, 56(2), 375-386. doi: 10.1016/S0277-9536(02)00043-6
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. Journal of personality and social psychology, 39(3), 472. doi: 10.1037/0022-3514.39.3.472
Samwel, H. J., Evers, A. W., Crul, B. J., & Kraaimaat, F. W. (2006). The role of helplessness, fear of pain, and passive pain-coping in chronic pain patients. The
72365.f5
Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7(4), 422–445. https://doi.org/10.1037/1082-989X.7.4.422
Söderlund, A., & Åsenlöf, P. (2010). The mediating role of self-efficacy expectations and fear of movement and (re) injury beliefs in two samples of acute
pain. Disability and rehabilitation, 32(25), 2118-2126. doi: 10.3109/09638288.2010.483036
Tsai, Y. F., Liu, L. L., & Chung, S. C. (2010). Pain prevalence, experiences, and self- care management strategies among the community-dwelling elderly in
Taiwan. Journal of Pain and Symptom Management, 40(4), 575-581. doi: 10.1016/j.jpainsymman.2010.02.013
Tomaka, J., Thompson, S., & Palacios, R. (2006). The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. Journal of aging and health, 18(3), 359-384. doi: 10.1177/0898264305280993
Vlaeyen, J. W., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317-332. doi: 10.1016/S0304-3959(99)00242-0
Vowles, K. E., McCracken, L. M., & Eccleston, C. (2007). Processes of change in treatment for chronic pain: the contributions of pain, acceptance, and catastrophizing. European journal of pain, 11(7), 779-787. doi: 10.1016/j.ejpain.2006.12.007
Vowles, K. E., McCracken, L. M., McLeod, C., & Eccleston, C. (2008). The Chronic Pain Acceptance Questionnaire: confirmatory factor analysis and identification of patient subgroups. Pain, 140(2), 284-291.doi: 10.1016/j.pain.2008.08.012
Weiss, R. S. (1973). Loneliness: The experience of emotional and social isolation. Cambridge, MA: The MIT Press.
West, S. G., Taylor, A. B., & Wu, W. (2012). Model fit and model selection in structural equation modeling. Handbook of structural equation modeling, 1, 209-231.
Yanguas, J., Pinazo-Henandis, S., & Tarazona-Santabalbina, F. J. (2018). The complexity of loneliness. Acta Bio Medica: Atenei Parmensis, 89(2), 302. doi: 10.23750/abm.v89i2.7404
描述 碩士
國立政治大學
心理學系
107752002
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0107752002
資料類型 thesis
dc.contributor.advisor 吳治勳zh_TW
dc.contributor.advisor Wu, Chih-Hsunen_US
dc.contributor.author (Authors) 楊皓涵zh_TW
dc.contributor.author (Authors) Yang, Hao-Hanen_US
dc.creator (作者) 楊皓涵zh_TW
dc.creator (作者) Yang, Hao-Hanen_US
dc.date (日期) 2022en_US
dc.date.accessioned 1-Aug-2022 18:10:35 (UTC+8)-
dc.date.available 1-Aug-2022 18:10:35 (UTC+8)-
dc.date.issued (上傳時間) 1-Aug-2022 18:10:35 (UTC+8)-
dc.identifier (Other Identifiers) G0107752002en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/141170-
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) 107752002zh_TW
dc.description.abstract (摘要) 研究背景:許多研究指出,疼痛接受度對慢性疼痛患者的身心適應狀態有正向影 響。從反抗疼痛到接納疼痛、與疼痛共處,患者在過程會歷經許多困難,藉由現 象觀察及文獻回顧,本研究歸納出疼痛強度、寂寞感及疼痛自我效能是可能影響 疼痛接受度的因素,並提出一路徑模式。透過臨床追蹤研究,本研究試圖釐清疼 痛強度、寂寞感及疼痛自我效能三者與疼痛接受度的關係。
研究方法:以北部某教學醫學中心之慢性疼痛患者為研究對象,進行追蹤研究,起始點(T0)與追蹤(T1)間隔三個月。以疼痛評估量尺、慢性疼痛接受度量表 8題版(Chronic Pain Acceptance Questionnaire-8)、疼痛自我效能量表(Pain Self- Efficacy Questionnaire)、UCLA寂寞量表3題版(UCLA 3-item Loneliness Scale)、 慢性病負向情緒量表(Negative Emotions due to Chronic Illness Screening Test)作為測量工具,評估疼痛強度、疼痛接受度(包含「活動參與」與「甘願疼痛」兩 個概念)、疼痛自我效能、寂寞感及負向情緒。路徑分析部分,先以描述統計檢視各研究變項,並利用結構方程模型進行分析,檢視所提出模式是否適配,並探討T0疼痛強度、寂寞感、自我效能、疼痛接受度以及T1疼痛強度與負向情緒之關係。
研究結果:共有176位參與者完成起始點(T0)及三個月追蹤(T1)之評估,平均年齡為60.32歲(SD = 13.76),平均疼痛強度為6.00(SD = 2.63),平均持續 時間為96.52個月(SD = 109.65)。結果發現年齡與負向情緒各自和研究變項有顯著相關,故將年齡以共變項加入模式進行控制,負向情緒則分為高、低負向情緒兩組進行多組並行之路徑分析。路徑分析之參數估計結果顯示(1)全樣本之自我效能能夠正向預測活動參與(β = .42, p = .004),寂寞感能夠負向預測活動參 與(β = -.28, p = .004);自我效能能夠完全中介疼痛強度對活動參與之關係(Effect Size(ES)=-.10,p=.010),部分中介寂寞感對活動參與之關係(ES=-.12,p=.004); 活動參與能夠負向預測疼痛強度(β = -.16, p = .027)及負向情緒(β = -.36, p = .004)。(2)高負向情緒組之寂寞感能夠負向預測活動參與(β = -.24, p = .033), 自我效能能夠正向預測活動參與(β = .36, p = .004),並部分中介寂寞感對活動參與之關係(ES = -.12, p = .011)。活動參與能夠負向預測疼痛強度(β = -.22, p = .047)及負向情緒(β = -.33, p = .010)。(3)低負向情緒組之自我效能能夠正向預測活動參與(β= .52, p = .004),並完全中介疼痛強度對活動參與之關係(ES = -.23, p = .004);活動參與能夠負向預測負向情緒(β = -.48, p = .004)。此外,甘願疼痛無法被任何因素預測,亦無法預測疼痛強度與負向情緒。
討論與結論:本研究發現自我效能對於疼痛接受度有正向預測效果,疼痛接受度能夠正向預測疼痛強度與負向情緒。此結果在臨床上有重要的意義,因自我效能在過去研究中被證實能夠透過相關臨床心理介入提升,因此若能夠藉由自我效能之介入提升自我效能,或許能夠改善患者疼痛接受度並緩解疼痛強度與負向情緒狀態。此外,區辨慢性疼痛患者負向情緒狀態亦有重要的臨床意義:高負向情緒的患者,自我效能顯著受到寂寞感之負向影響;低負向情緒之患者,自我效能則顯著受到疼痛強度之負向影響。在進行照顧時,若能夠先評估患者之負向情緒狀態,可以更有效率地提供適合的介入。未來研究若能夠拓展收案場域至社區,進一步探索患者之不同特徵對本模型的影響,並納入生活品質等較整體性適應評估,或許能夠使疼痛接受之概念與模型更加完整,優化疼痛整體性照護。
zh_TW
dc.description.abstract (摘要) Background: Many studies have found that pain acceptance positively affects physical and psychological adaptation in chronic pain patients. It is a suffering process, from resisting pain to accepting pain and living with pain for the patients. Through clinical observations and literature review, this study suggested that pain intensity, loneliness, and pain self-efficacy are the factors that may affect pain acceptance. This study proposes a path model to explore the relationships among pain intensity, loneliness, pain self-efficacy, and pain acceptance in a clinical longitudinal study.
Methods: Chronic pain patients were recruited from pain clinics in a medical center in northern Taiwan. Participants were asked to fill the following scales: pain intensity scale, Chronic Pain Acceptance Questionnaire-8, Pain Self-Efficacy Questionnaire, UCLA 3-item Loneliness Scale, and Negative Emotions due to Chronic Illness Screening Test (NECIS) to assess pain intensity, pain acceptance (including “Activity Engagement (AE)” and “Pain Willingness (PW)”), pain self-efficacy, loneliness, and negative emotion, at baseline (T0) and 3-month follow-up (T1). Descriptive and comparative statistics were used to describe the data. Structural equation modeling was used to perform path analysis. To examine the goodness-of-fit of the model and the relationships among pain intensity, loneliness, self-efficacy, pain acceptance, and follow-up pain intensity and negative emotion.
Results: There were 176 participants completed both T0 and T1 evaluations. The mean age of the participants was 60.32 (SD = 13.76), the mean pain intensity was 6.00 (SD = 2.63), and the mean duration was 96.52 months (SD = 109.65). The results showed that age and negative emotions were significantly correlated with other variables. Thus, age was controlled by included as a covariate to the model, and negative emotions were used as a grouping variable to separate high and low negative emotions for a multi-group path analysis. The results of the parameter estimations showed that (1) All participants: self-efficacy can positively predict Activity Engagement(AE) (β = .42, p = .004) of pain acceptance, and loneliness can negatively predict AE (β = -.28, p = .004); self-efficacy fully mediates the relationship between pain intensity and AE (Effect Size (ES) = -.10, p = .010), and partially mediates the relationship between loneliness and AE (ES = -.12, p = .004); AE can negatively predicted pain intensity (β = -.16, p = .027) and negative emotion (β = -.36, p = .004). (2) High negative emotion group: loneliness can negatively predict AE (β = -.24, p = .033), and self-efficacy can positively predict AE (β = .36, p = .004), and partially mediate the relationship between loneliness and AE (ES = -.12, p = .011). AE can negatively predicted pain intensity (β = -.22, p = .047) and negative emotion (β = -.33, p = .010). (3) Self-efficacy in the low negative emotion group can predict AE (β= .52, p = .004), and completely mediate the relationship between pain intensity and AE (ES = -.23, p = .004); AE can negatively predict negative emotion (β = -.48, p = .004). In addition, pain willingness was not predicted by any variables, nor could it predict any pain indicators.
Discussion and conclusion: This study found that self-efficacy positively affects pain acceptance, and pain acceptance can positively predict pain adaptation. This result may provide a clinically significant meaning, as past studies have proven that self-efficacy can be improved through clinical psychological intervention. Therefore, patients` pain acceptance might be improved through self-efficacy intervention. Furthermore, self- efficacy is significantly affected by loneliness in patients with high negative emotions but significantly affected by pain intensity in the low negative emotion group. Thus, interventions can be provided more efficiently if the patient`s negative emotions can be assessed for further care. Finally, to expand the model`s generalizability and further explore the phenomena of pain acceptance, future research should extend the sample
from clinical to the community, explore the influence of patients` different characteristics on this model, and incorporate more holistic adaptation assessments such as quality of life.
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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.............................................4
一、慢性疼痛................................................4
二、疼痛接受................................................9
三、自我效能與疼痛相關自我效能................................20
四、寂寞感.................................................27
五、疼痛強度、寂寞感與自我效能.................................30
第三節 研究架構與假設........................................32
第二章 研究方法.............................................33
第一節 研究參與者與研究流程...................................33
第二節 研究工具.............................................34
一、疼痛評估與基本資料.......................................34
二、疼痛接受度..............................................34
三、疼痛自我效能............................................35
四、寂寞感.................................................35
五、負向情緒...............................................36
第三節 資料分析.............................................37
一、遺漏值處理..............................................37
二、描述統計與差異檢定.......................................37
三、疼痛自我效能量表與慢性疼痛接受度量表 8 題版心理計量探索........37
四、疼痛接受模型檢驗.........................................37
第三章 研究結果.............................................40
第一節 描述性統計...........................................40
第二節 疼痛自我效能量表與慢性疼痛接受度量表 8 題版心理計量探索....44
一、疼痛自我效能量表........................................44
二、慢性疼痛接受度量表.......................................48
第三節 疼痛接受模型檢驗......................................50
一、各變項之相關與差異檢定....................................50
二、路徑分析...............................................53
第四章 討論................................................68
第ㄧ節 自我效能對疼痛接受度的影響..............................68
第二節 高、低負向情緒分組的差異................................81
一、高負向情緒組的路徑模式....................................87
二、低負向情緒組的路徑模式....................................89
第三節 疼痛接受度對疼痛強度與負向情緒的影響......................91
第三節 研究貢獻、限制與未來方向................................94
一、研究貢獻與臨床應用.......................................94
二、研究限制與未來方向.......................................95
參考文獻 ..................................................97
附錄 ....................................................106
一、慢性疼痛接受度量表 8 題版................................106
二、疼痛自我效能量表........................................107
三、UCLA 寂寞量表 3 題版...................................108
四、慢性病負向情緒量表......................................108
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dc.format.extent 4154136 bytes-
dc.format.mimetype application/pdf-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0107752002en_US
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) 疼痛強度zh_TW
dc.subject (關鍵詞) 寂寞感zh_TW
dc.subject (關鍵詞) 負向情緒zh_TW
dc.subject (關鍵詞) pain acceptanceen_US
dc.subject (關鍵詞) pain self-efficacyen_US
dc.subject (關鍵詞) pain intensityen_US
dc.subject (關鍵詞) lonelinessen_US
dc.subject (關鍵詞) negative emotionen_US
dc.title (題名) 以縱貫資料初探慢性疼痛患者疼痛強度、自我效能、寂寞感、及疼痛接受度之關係zh_TW
dc.title (題名) Exploring the Relationship among Pain Intensity, Self-efficacy, Loneliness, and Pain Acceptance in Chronic Pain Patients: A Longitudinal Studyen_US
dc.type (資料類型) thesisen_US
dc.relation.reference (參考文獻) Allen, S. F., Gilbody, S., Atkin, K., & van der Feltz-Cornelis, C. (2020). The associations between loneliness, social exclusion and pain in the general population: AN= 502,528 cross-sectional UK Biobank study. Journal of psychiatric research, 130, 68-74. doi: 10.1016/j.jpsychires.2020.06.028
Archer, K. R., Castillo, R. C., Wegener, S. T., Abraham, C. M., & Obremskey, W. T. (2012). Pain and satisfaction in hospitalized trauma patients: the importance of self-efficacy and psychological distress. Journal of Trauma and Acute Care Surgery, 72(4), 1068-1077. doi: 10.1097/TA.0b013e3182452df5
Arnstein, P., Caudill, M., Mandle, C. L., Norris, A., & Beasley, R. (1999). Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain, 80(3), 483-491. doi: 10.1016/S0304- 3959(98)00220-6
Bandura, A. (1994). Self-efficacy. In V. S. Ramachaudran (Ed.), Encyclopedia of human behavior (Vol. 4, pp. 71-81). New York, NY: Academic Press.
Bandura, A., Freeman, W. H., & Lightsey, R. (1999). Self-efficacy: The exercise of control. New York, NY: Worth Publishers
Barlow, J. H., Cullen, L. A., & Rowe, I. (2002). Educational preferences, psychological well-being and self-efficacy among people with rheumatoid arthritis. Patient education and counseling, 46(1), 11-19. doi: 10.1016/S0738- 3991(01)00146-X
Barlow, J. H., Turner, A. P., & Wright, C. C. (2000). A randomized controlled study of the Arthritis Self-Management Programme in the UK. Health education research, 15(6), 665-680. doi: 10.1093/her/15.6.665
Barlow, J. H., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002). Self- management approaches for people with chronic conditions: a review. Patient education and counseling, 48(2), 177-187. doi: 10.1016/S0738-3991(02)00032- 0
Blyth, F. M., March, L. M., Brnabic, A. J., Jorm, L. R., Williamson, M., & Cousins, M. J. (2001). Chronic pain in Australia: a prevalence study. Pain, 89(2-3), 127- 134. doi: 10.1016/S0304-3959(00)00355-9
Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: prevalence, impact on daily life, and
treatment. European journal of pain, 10(4), 287-333. doi: 10.1016/j.ejpain.2005.06.009
Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychology and aging, 21(1), 140. doi: 10.1037/0882- 7974.21.1.140
Costa, L. D. C. M., Maher, C. G., McAuley, J. H., Hancock, M. J., & Smeets, R. J. (2011). Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain. European Journal of Pain, 15(2), 213-219. doi: 10.1016/j.ejpain.2010.06.014
Council, J. R., Ahern, D. K., Follick, M. J., & Kline, C. L. (1988). Expectancies and functional impairment in chronic low back pain. Pain, 33(3), 323-331. doi: 10.1016/0304-3959(88)90291-6
Damush, T. M., Kroenke, K., Bair, M. J., Wu, J., Tu, W., Krebs, E. E., & Poleshuck, E. (2016). Pain self‐management training increases self‐efficacy, self‐ management behaviours and pain and depression outcomes. European Journal of Pain, 20(7), 1070-1078. doi: 10.1002/ejp.830
de Jong-Gierveld, J. (1987). Developing and testing a model of loneliness. Journal of personality and social psychology, 53(1), 119.
de Jong Gierveld, J. (1998). A review of loneliness: concept and definitions, determinants and consequences. Reviews in Clinical Gerontology, 8(1), 73-80. doi: 10.1017/S0959259898008090
DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of internal medicine, 160(14), 2101-2107. doi: 10.1001/archinte.160.14.2101
Dolce, J. J., Doleys, D. M., Raczynski, J. M., Lossie, J., Poole, L., & Smith, M. (1986). The role of self-efficacy expectancies in the prediction of pain tolerance. Pain, 27(2), 261-272. doi: 10.1016/0304-3959(86)90216-2
Emerson, K., Boggero, I., Ostir, G., & Jayawardhana, J. (2018). Pain as a risk factor for loneliness among older adults. Journal of aging and health, 30(9), 1450- 1461. doi: 10.1177/0898264317721348
Feldman, S. I., Downey, G., & Schaffer-Neitz, R. (1999). Pain, negative mood, and perceived support in chronic pain patients: A daily diary study of people with reflex sympathetic dystrophy syndrome. Journal of Consulting and Clinical psychology, 67(5), 776. doi: 10.1037/0022-006X.67.5.776
Fish, R. A., McGuire, B., Hogan, M., Morrison, T. G., & Stewart, I. (2010). Validation of the Chronic Pain Acceptance Questionnaire (CPAQ) in an Internet sample and development and preliminary validation of the CPAQ-
8. Pain, 149(3), 435-443. doi: 10.1016/j.pain.2009.12.016
Garbi, M. D. O. S. S., Hortense, P., Gomez, R. R. F., Silva, T. D. C. R. D., Castanho, A. C. F., & Sousa, F. A. E. F. (2014). Pain intensity, disability and depression in individuals with chronic back pain. Revista latino-americana de enfermagem, 22, 569-575. doi: 10.1590/0104-1169.3492.2453
Hacihasanoğlu, R., Yildirim, A., & Karakurt, P. (2012). Loneliness in elderly individuals, level of dependence in activities of daily living (ADL) and influential factors. Archives of gerontology and geriatrics, 54(1), 61-66. doi: 10.1016/j.archger.2011.03.011
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of behavioral medicine, 40(2), 218-227. doi: 10.1007/s12160-010-9210-8
Hawkley, L. C., Masi, C. M., Berry, J. D., & Cacioppo, J. T. (2006). Loneliness is a unique predictor of age-related differences in systolic blood
pressure. Psychology and aging, 21(1), 152. doi: 10.1037/0882-7974.21.1.152
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 44(1), 1-25. doi: 10.1016/j.brat.2005.06.006
Huang, Y. H., Wu, C. H., Chen, H. J., Cheng, Y. R., Hung, F. C., Leung, K. K., ... & Wu, Y. C. (2018). Quick screening tool for patients with severe negative emotional reactions to chronic illness: psychometric study of the negative emotions due to chronic illness screening test (NECIS). Family practice, 35(1), 34-40. doi: 10.1093/fampra/cmx076
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on aging, 26(6), 655-672. doi: 10.1177/0164027504268574
IASP. (2019). Definitions of Chronic Pain Syndromes. Retrieved from https://www.iasp-pain.org/advocacy/definitions-of-chronic-pain-syndromes/
IASP. (2020). IASP Announces Revised Definition of Pain. Retrieved from
https://www.iasp-pain.org/PublicationsNews/NewsDetail.aspx?ItemNumber=10475
Jaremka, L. M., Andridge, R. R., Fagundes, C. P., Alfano, C. M., Povoski, S. P., Lipari, A. M., ... & Kiecolt-Glaser, J. K. (2014). Pain, depression, and fatigue: loneliness as a longitudinal risk factor. Health Psychology, 33(9), 948. doi: 10.1037/a0034012
Jaremka, L. M., Fagundes, C. P., Glaser, R., Bennett, J. M., Malarkey, W. B., & Kiecolt-Glaser, J. K. (2013). Loneliness predicts pain, depression, and fatigue: understanding the role of immune dysregulation. Psychoneuroendocri- nology, 38(8), 1310-1317. doi: 10.1016/j.psyneuen.2012.11.016
Jensen, M. P., Moore, M. R., Bockow, T. B., Ehde, D. M., & Engel, J. M. (2011). Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: a systematic review. Archives of physical medicine and rehabilitation, 92(1), 146-160. doi: 10.1016/j.apmr.2010.09.021
Jensen, M. P., Turner, J. A., & Romano, J. M. (1991). Self-efficacy and outcome expectancies: relationship to chronic pain coping strategies and adjustment. Pain, 44(3), 263-269. doi: 10.1016/0304-3959(91)90095-F
LaChapelle, D. L., Lavoie, S., & Boudreau, A. (2008). The meaning and process of pain acceptance. Perceptions of women living with arthritis and fibromyalgia. Pain Research and Management, 13(3), 201-210. doi: 10.1155/2008/258542
Lackner, J. M., & Carosella, A. M. (1999). The relative influence of perceived pain control, anxiety, and functional self efficacy on spinal function among patients with chronic low back pain. Spine, 24(21), 2254. doi: 10.1097/00007632- 199911010-00014
Lackner, J. M., Carosella, A. M., & Feuerstein, M. (1996). Pain expectancies, pain, and functional self-efficacy expectancies as determinants of disability in patients with chronic low back disorders. Journal of consulting and clinical psychology, 64(1), 212. doi: 10.1037/0022-006X.64.1.212
Lauder, W., Mummery, K., Jones, M., & Caperchione, C. (2006). A comparison of health behaviours in lonely and non-lonely populations. Psychology, Health & Medicine, 11(2), 233-245. doi: 10.1080/13548500500266607
Litt, M. D. (1988). Self-efficacy and perceived control: cognitive mediators of pain tolerance. Journal of personality and social psychology, 54(1), 149. doi: 10.1037/0022-3514.54.1.149
Loeffler, A., & Steptoe, A. (2021). Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation. Pain, 162(3), 930. doi: 10.1097/j.pain.0000000000002082
Lorig, K., Chastain, R. L., Ung, E., Shoor, S., & Holman, H. R. (1989). Development and evaluation of a scale to measure perceived self‐efficacy in people with arthritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 32(1), 37-44. doi: 10.1002/anr.1780320107
Lorig, K., & Holman, H. (1993). Arthritis self-management studies: a twelve-year review. Health education quarterly, 20(1), 17-28. doi: 10.1177/1090198193020 00104
Kamper, S. J., Apeldoorn, A. T., Chiarotto, A., Smeets, R. J., Ostelo, R. W., Guzman, J., & van Tulder, M. (2015). Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. Bmj,
Keefe, F. J., Caldwell, D. S., Queen, K. T., Gil, K. M., Martinez, S., Crisson, J. E., ... & Nunley, J. (1987). Pain coping strategies in osteoarthritis patients. Journal of consulting and clinical psychology, 55(2), 208. doi: 10.1037/0022- 006X.55.2.208
Kostova, Z., Caiata-Zufferey, M., & Schulz, P. J. (2014a). The impact of social support on the acceptance process among RA patients: a qualitative study. Psychology & health, 29(11), 1283-1302. doi: 10.1080/08870446.2014.925895
Kostova, Z., Caiata-Zufferey, M., & Schulz, P. J. (2014b). The process of acceptance among rheumatoid arthritis patients in Switzerland: a qualitative study. Pain Research and Management, 19(2), 61-68. doi: 10.1155/2014/168472
MacKinnon, D. P. (2012). Introduction to statistical mediation analysis: Routledge
Maguire, R., Hanly, P., & Maguire, P. (2021). Living well with chronic illness: How social support, loneliness and psychological appraisals relate to well-being in a population-based European sample. Journal of health psychology, 26(10), 1494- 1507. Doi: 10.1177/1359105319883923
McCracken, L. M. (1998). Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain, 74(1), 21-27. doi: 10.1016/S0304-3959(97)00146-2
McCracken, L. M. (1999). Behavioral constituents of chronic pain acceptance: Results from factor analysis of the Chronic Pain Acceptance
Questionnaire. Journal of Back and Musculoskeletal Rehabilitation, 13(2-3), 93-100. doi: 10.3233/BMR-1999-132-306
McCracken, L. M. (2005). Social context and acceptance of chronic pain: the role of solicitous and punishing responses. Pain, 113(1-2), 155-159. doi: 10.1016/j. pain.2004.10.004
McCracken, L. M., Carson, J. W., Eccleston, C., & Keefe, F. J. (2004). Acceptance
pain.2004.02.006
McCracken, L. M., & Eccleston, C. (2003). Coping or acceptance: what to do about
chronic pain?. Pain, 105(1-2), 197-204. doi: 10.1016/S0304-3959(03)00202-1
McCracken, L. M., & Eccleston, C. (2005). A prospective study of acceptance of pain and patient functioning with chronic pain. Pain, 118(1-2), 164-169. doi: 10.1016/j.pain.2005.08.015
McCracken, L. M., & Eccleston, C. (2006). A comparison of the relative utility of coping and acceptance-based measures in a sample of chronic pain sufferers.
McCracken, L. M., Spertus, I. L., Janeck, A. S., Sinclair, D., & Wetzel, F. T. (1999). Behavioral dimensions of adjustment in persons with chronic pain: pain-related anxiety and acceptance. Pain, 80(1-2), 283-289. doi: 10.1016/S0304- 3959(98)00219-X
McCracken, L. M., Vowles, K. E., & Eccleston, C. (2004). Acceptance of chronic pain: component analysis and a revised assessment method. Pain, 107(1-2), 159-166. doi: 10.1016/j.pain.2003.10.012
McCracken, L. M., Vowles, K. E., & Eccleston, C. (2005). Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour research and therapy, 43(10), 1335-1346. doi: 10.1016/j.brat.2004.10.003
McGorry, R. W., Webster, B. S., Snook, S. H., Hsiang, S. M. (2000). The relation between pain intensity, disability, and the episodic nature of chronic and recurrent low back pain. Spine, 25: 834–841.
McWilliams, L. A., Cox, B. J., & Enns, M. W. (2003). Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain, 106(1-2), 127-133. doi: 10.1016/S0304-3959(03)00301-4
Means‐Christensen, A. J., Roy‐Byrne, P. P., Sherbourne, C. D., Craske, M. G., & Stein, M. B. (2008). Relationships among pain, anxiety, and depression in primary care. Depression and anxiety, 25(7), 593-600. doi: 10.1002/da.20342
Melzack, R., & Wall, P. D. (1965). Pain mechanisms: a new theory. Science, 150(3699), 971-979.
Meredith, P., Strong, J., & Feeney, J. A. (2006). Adult attachment, anxiety, and pain self-efficacy as predictors of pain intensity and disability. Pain, 123(1-2), 146- 154. doi: 10.1016/j.pain.2006.02.025
Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V., & Ustun, B. (2007). Depression, chronic diseases, and decrements in health: results from the World Health Surveys. The Lancet, 370(9590), 851-858. doi: doi.org/10.1016/S0140- 6736(07)61415-9
National Academies of Sciences, Engineering, and Medicine. (2020). Social isolation and loneliness in older adults: Opportunities for the health care system. Washington, DC: National Academies Press.
Nicassio, P. M., & Wallston, K. A. (1992). Longitudinal relationships among pain, sleep problems, and depression in rheumatoid arthritis. Journal of abnormal psychology, 101(3), 514. doi: 10.1037/0021-843X.101.3.514
Nicholas, M. K. (1989). Self-efficacy and chronic pain. In St Andrews: Annual Conference of British Psychological Society, 1989.
Nicholas, M. K. (2007). The pain self-efficacy questionnaire: taking pain into account. European journal of pain, 11(2), 153-163. doi: 10.1016/j.ejpain.2005.12.008
Nicholas, M. K., & Asghari, A. (2006). Investigating acceptance in adjustment to chronic pain: Is acceptance broader than we thought?. Pain, 124(3), 269-279. doi: 10.1016/j.pain.2006.04.032
Penninx, B. W., Van Tilburg, T., Kriegsman, D. M., Boeke, A. J. P., Deeg, D. J., & Van Eijk, J. T. M. (1999). Social network, social support, and loneliness in older persons with different chronic diseases. Journal of aging and health, 11(2), 151-168. doi: 10.1177/089826439901100202
Risdon, A., Eccleston, C., Crombez, G., & McCracken, L. (2003). How can we learn to live with pain? A Q-methodological analysis of the diverse understandings of acceptance of chronic pain. Social science & medicine, 56(2), 375-386. doi: 10.1016/S0277-9536(02)00043-6
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. Journal of personality and social psychology, 39(3), 472. doi: 10.1037/0022-3514.39.3.472
Samwel, H. J., Evers, A. W., Crul, B. J., & Kraaimaat, F. W. (2006). The role of helplessness, fear of pain, and passive pain-coping in chronic pain patients. The
72365.f5
Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7(4), 422–445. https://doi.org/10.1037/1082-989X.7.4.422
Söderlund, A., & Åsenlöf, P. (2010). The mediating role of self-efficacy expectations and fear of movement and (re) injury beliefs in two samples of acute
pain. Disability and rehabilitation, 32(25), 2118-2126. doi: 10.3109/09638288.2010.483036
Tsai, Y. F., Liu, L. L., & Chung, S. C. (2010). Pain prevalence, experiences, and self- care management strategies among the community-dwelling elderly in
Taiwan. Journal of Pain and Symptom Management, 40(4), 575-581. doi: 10.1016/j.jpainsymman.2010.02.013
Tomaka, J., Thompson, S., & Palacios, R. (2006). The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. Journal of aging and health, 18(3), 359-384. doi: 10.1177/0898264305280993
Vlaeyen, J. W., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317-332. doi: 10.1016/S0304-3959(99)00242-0
Vowles, K. E., McCracken, L. M., & Eccleston, C. (2007). Processes of change in treatment for chronic pain: the contributions of pain, acceptance, and catastrophizing. European journal of pain, 11(7), 779-787. doi: 10.1016/j.ejpain.2006.12.007
Vowles, K. E., McCracken, L. M., McLeod, C., & Eccleston, C. (2008). The Chronic Pain Acceptance Questionnaire: confirmatory factor analysis and identification of patient subgroups. Pain, 140(2), 284-291.doi: 10.1016/j.pain.2008.08.012
Weiss, R. S. (1973). Loneliness: The experience of emotional and social isolation. Cambridge, MA: The MIT Press.
West, S. G., Taylor, A. B., & Wu, W. (2012). Model fit and model selection in structural equation modeling. Handbook of structural equation modeling, 1, 209-231.
Yanguas, J., Pinazo-Henandis, S., & Tarazona-Santabalbina, F. J. (2018). The complexity of loneliness. Acta Bio Medica: Atenei Parmensis, 89(2), 302. doi: 10.23750/abm.v89i2.7404
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dc.identifier.doi (DOI) 10.6814/NCCU202200746en_US