心理因素对不同种类疾病慢性疼痛的影响

目的 对比分析不同疾病慢性疼痛与抑郁、焦虑、社会支持等心理社会因素的关系,为综合管理慢性疼痛提供参考.方法 采用医院焦虑抑郁量表（HADS）、领悟社会支持量表（PSSS）及疼痛强度简易描述量表（VRS）对来自不同医院科室的癌症患者、腰椎间盘突出症患者、心绞痛患者进行问卷调查,并采用方差分析、相关及回归分析,对比3类疾病患者疼痛程度与心理社会因素的关系.结果 癌症患者疼痛程度与抑郁、焦虑、社会支持显著相关（r =0.53,0.43,-0.32；P＜0.05）；腰椎间盘突出症患者疼痛程度与焦虑、社会支持显著相关（r =0.18,-0.26；P＜0.05）；心绞痛患者疼痛程度与焦虑显著相关（r=0.35,P＜0.01）.回归分析发现,影响癌症患者疼痛程度的主要为抑郁和社会支持（Beta=0.40,-0.16；P＜0.05）,影响腰椎间盘突出症患者疼痛程度的主要为焦虑和社会支持（Beta=0.15,-0.24；P＜0.05）,影响心绞痛患者疼痛程度的主要为焦虑（Beta=0.36,P＜0.05）.结论 心理社会因素对慢性疼痛具有复杂的影响,而且对不同疾病患者具有不同的影响,应综合分析,区别对待.

Impact of Psychological Factors on Chronic Pain from Different Diseases

Objective To analyze the impacts of psychological factors, such as depression, anxiety, and social support, on chronic pain from different diseases. Methods Using Hospital Anxiety and Depression Scale （HADS） , Perceived Social Support Scale （PSSS） , and Verbal Rating Scale （VRS） to investigate chronic pain patients from different departments of different hospitals, including cancer, lum- bar disc protrusion, and angina. ANOVA, correlation and regression analysis were used to compare the influences of psychological factors on chronic pain from different diseases. Results Chronic pain from cancer patients had significant correlation with depression, anxiety and social support（ r = 0. 53,0. 43,4）. 32 ;P 〈 0.05 ） ;Pain from lumbar disc protrusion patients had significant correlations with anxiety and social support（ r =0. 18 ,-0. 26 ;P 〈0.05 ） ;And from angina patients had significant correlation with anxiety（ r = 0. 35 ,P 〈 0.01 ）. Results of regression showed that factors influenced pain severity of cancer patients were depression and social support （ Beta = 0.40, 4）. 16 ; P 〈 0.05 ）. Ones influenced pain severity of lumbar disc protrusion patients were anxiety and social support （ Beta = 0.15,4）. 24 ; P 〈 0.05 ）. And factor influenced pain severity of angina patients was anxlety （ Beta = 0.36, P 〈 0. 05 ）. Conclusion Psychological and social factors have complicated impacts on chronic pain severity, and the impacts differs between different diseases. So it needs to be treated based on the characteristics of diseases itself,to well manage this important symptom.