慢性疼痛患者生活质量影响因素的路径分析

Path analysis on influential factors in quality of life of patients with chronic pain

目的探讨慢性疼痛患者生活质量的影响因素。方法采用一般调查问卷、简明MiGill疼痛量表、BECK抑郁自评问卷、BECK焦虑自评问卷、疼痛自我效能量表、阿森斯失眠量表、SF-12生活质量量表对114例健康人群和139例慢性疼痛患者进行对比分析。结果慢性疼痛患者焦虑[（33．56±9．96）分]、抑郁[（17．14±11．22）分]、失眠[（13．19±6．14）分]得分均高于正常组[分别为（24．55±4．49）分，（24．55±4．49）分，（3．68±3．12）分]，疼痛自我效能和生活质量得分均低于正常组，差异有显著性（P〈0．01）；不同疼痛程度（F=3．92，P=0．005）、不同疼痛部位数目（F=2．39，P=0．041）的慢性疼痛患者生活质量得分差异有显著性，不同疼痛频率的患者生活质量得分差异无显著性（F=1．54，P=0．169）；生活质量得分与疼痛总分（r=-0．383）、感觉疼痛（r=-0．315）、情感疼痛（r=-0．434）、疼痛自我效能（r=-0．570）、焦虑（r=-0．640）、抑郁（r=-0．523）及失眠（r=-0．508）得分均显著相关沪〈0．05）；疼痛自我效能、抑郁、焦虑和失眠得分进入慢性疼痛患者生活质量的多元线性回归方程；失眠和抑郁可以通过疼痛自我效能，失眠也可以通过抑郁间接影响慢性疼痛患者的生活质量。结论慢性疼痛患哲生活质量受到多个因素的影响，要提高其生活质量，要多方位的采取干预措施。

Objective To explore the factors that influence the quality of life of patients with chronic pain. Methods Using self-designed questionnaire,simple MiGill pain questionnaire,Beck depression inventory, Beck anxiety inventory,pain self-efficiency questionnaire,athens insomnia scale and SF-12 scale to investigate 114 health people and 139 patients with chronic pain ,and analyze the data with analysis of variance and linear regression analysis and path analysis. Results Scores of anxiety （33.56 ±9.96） , depression （ 17.14 ± 11.22） ,and insomnia （13.19 ±6.14） in patients with chronic pain was significant higher（P〈 0.01 ） than the health people （24.55±4.49,24.55 ±4.49,3.68 ± 3.12 independently） ,and scores of pain self-control and quality of life（ ineluding physical health and mental health） scored lower （P 〈 0.01 ） than the health group. Scores of quality of life in chronic pain patients with different pain intensity （F= 3.92, P = 0. 005 ） and different ache numbers （F = 2.39, P= 0.041 ）were significant different, while scores of quality of life in chronic pain patients with different ache frequency was not significant different （F = 1.54, P = 0. 169） ; quality of life score was significantly correlated （P 〈 0.05）to the total pain （r= -0. 383） ,the feeling pain （r= -0. 315） ,the emotion pain （r= -0. 434） ,pain selfcontrol （r = 0. 570） ,anxiety （r = - 0. 640） , depression （r = - 0. 523 ） and insomnia （r = - 0. 508 ）, Pain self-control,depression,anxiety and insomnia insomnia and depression may indirectly influence the chronie pain patient＇s quality of life through pain self-control, and insomnia also can affect the quality of life through depression. Conclusion The quality of life in patients with chronic pain was influenced by a number of factors,so it is necessary to take muhi-faceted interventions to improve their quality of life.