慢性疼痛患者的社会比较倾向及其对疼痛应对方式的影响

摘要

目的 探讨慢性疼痛患者的社会比较倾向及其对疼痛应对方式的影响.方法 采用方便抽样法,选取2017年4-8月在四川大学华西医院疼痛科住院的慢性疼痛患者246例,采用社会比较倾向量表中文版、医学应对问卷调查患者的社会比较倾向和疼痛应对方式.采用Pearson相关分析、t检验、方差分析进行单因素分析和相关分析.使用多元线性逐步回归分析应对方式的影响因素.结果 246例慢性疼痛患者社会比较倾向得分为(36.32±8.25)分,其中能力维度(21.04±4.96)分,观念维度(15.28±4.43)分.应对方式中,面对维度(18.27±4.10)分,回避维度(16.45±3.69)分,屈服维度(16.22±3.58)分.Pearson相关分析显示,社会比较倾向与面对呈负相关(r=-0.347,P<0.05),与屈服呈正相关(r=0.385,P<0.05),与回避无相关性(r=0.112,P>0.05).多元线性逐步回归分析显示,社会比较倾向和婚姻状态是慢性疼痛患者面对应对方式的影响因素;病程、宗教信仰和是否独居是患者回避应对方式的影响因素;社会比较倾向和病程是患者屈服应对方式的影响因素.结论 医护人员应注重患者的配偶支持程度,建立适合实际情况的独居患者的定期慰问及上门随访制度,并结合患者的社会比较倾向,综合使用各种比较方法,促进患者积极应对慢性疼痛.%Objective To explore the social comparison orientation in chronic pain patients and its effectiveness on coping style. Methods A total of 246 patients with chronic pain hospitalized in Pain Department of West China Hospital of Sichuan University from April 2017 to August 2018 were selected by convenience sampling. Chinese Version of the Social Comparison Orientation Scale and Medical Coping Modes Questionnaire were used to investigate the social comparison orientation and coping style. Univariate analysis and correlation analysis were performed using Pearson correlation analysis, t-test, analysis of variance test. Multivariate linear stepwise regression analysis was used to analyze influencing factors of coping style. Results Among 246 patients, the score of social comparison orientation was (36.32±8.25), with (21.04±4.96) in dimension of ability and (15.28±4.43) in dimension of viewpoint. The scores of facing, avoidance and yield coping style were (18.27±4.10), (16.45±3.69) and (16.22±3.58) respectively. Pearson correlation analysis showed that social comparison orientation negatively correlated with facing coping style (r=-0.347, P<0.05), positively correlated with yield coping style (r=0.385,P<0.05), and did not correlate with avoidance coping style (r=0.112,P> 0.05). Multivariate linear stepwise regression analysis revealed that social comparison orientation and marital status were influencing factors of patients' facing coping style; course of disease, religious and living alone affected avoidance coping style of patients; social comparison orientation and course of disease were influencing factors of yield coping style of patients. Conclusions Medical staff should emphasize spousal support, establish individual regular visiting and home follow-up for patients living alone, and use a variety of comparative methods to improve active coping methods combining with individual social comparison orientation.