当疼痛没有解决时,解决问题的风格发生变化. 在全膝关节置换术后,对患有慢性疼痛的成年人的纵向分析
Anna Gibby1, Maya Braun2,3, Wendy Bertram4,5
1Centre for Pain Research, University of Bath, Bath, United Kingdom.
Pain
|September 9, 2025
概括
在全膝关节置换术 (TKR) 后的慢性疼痛导致患者接受疼痛,而不是寻求解决方案. 然而,这种适应方式减少了生命的寿命.
科学领域:
- 整形外科 整形外科 整形外科
- 疼痛管理 疼痛管理
- 心理学 心理学 心理学
背景情况:
- 五分之一的成年人经历了全膝关节置换 (TKR) 后的慢性疼痛.
- 对疼痛的行为反应范围从积极追求止痛 (同化) 到接受 (适应).
研究的目的:
- 研究在TKR后经历慢性疼痛的患者问题解决方法 (同化与适应) 的转变.
- 检查这些解决问题的转变和心理社会结果之间的关系,包括生活的意义,疼痛的严重程度和膝盖功能.
主要方法:
- 一项涉及313名接受TKR的患者的试验比较了常规护理与增强护理途径.
- 患者的疼痛和心理社会结果,包括解决问题的策略,在手术后3个月被评估.
- 纵向分析追踪了手术后期问题解决能力的变化及其与其他结果的关联.
主要成果:
- 两个解决问题的子尺度转向了适应性方法 (解决痛苦,接受不可解决性),总体上对找到解决方案的信念下降.
- 尽管发生了这种转变,但参与者报告说,随着时间的推移,生活的意义降低了.
- 减少生活意义与增加疼痛严重程度,疼痛干扰和膝关节功能下降相关,不管护理途径如何.
结论:
- 在TKR后患有慢性疼痛的患者倾向于采取适应性解决问题的立场,但这并不等同于积极接受.
- 观察到的适应似乎是不适应的,与生活意义的减少以及疼痛和功能恶化的关系.
- 需要进一步的研究来理解和培养TKR后慢性疼痛的适应性应对机制.
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