放射性损伤疼痛患者疼痛灾难化现状及影响因素分析

Status quo and influencing factors of pain catastrophizing in patients with radiation injury pain

目的 探讨放射性损伤疼痛患者疼痛灾难化现状及影响因素,为临床预防及干预放射性损伤疼痛提供依据。方法选取2021年6月—2022年1月郑州大学第一附属医院收治的115例放射性损伤疼痛患者为研究对象。采用一般资料调查表、疼痛灾难化量表(PCS)、疼痛数字等级评分量表(NRS)、社会支持评定量表(SSRS)对患者进行横断面调查,分析疼痛程度、社会支持水平与疼痛灾难化水平的相关性,采用多元线性回归分析放射性损伤疼痛灾难化的影响因素。结果 115例放射性损伤疼痛患者PCS总分为(21.13±3.75)分,其中沉思维度得分为(4.52±2.87)分、夸大维度得分为(4.59±3.41)分、无助维度得分为(11.74±7.45)分。患者疼痛灾难化发生率为18.26%。不同年龄、放疗部位、文化程度、居住方式、患病时长、放射性损伤类型及放射性损伤分级的放射性损伤疼痛患者PCS评分比较,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,NRS评分与PCS总分及沉思、无助、夸大维度评分呈正相关(r=0.418、0.445、0.450、0.370,均P<0.05),SSRS评分与PCS总分及沉思、无助、夸大维度评分呈负相关(r=-0.339、-0.368、-0.411、-0.359,均P<0.05)。多元线性回归分析结果显示,年龄、放疗部位、居住方式、患病时长、放射性损伤类型、放射性损伤分级均是放射性损伤疼痛患者疼痛灾难化水平的影响因素(P<0.05)。结论 放射性损伤疼痛患者疼痛灾难化水平的影响因素较多,且患者疼痛程度与疼痛灾难化水平呈正相关,社会支持水平与疼痛灾难化水平呈负相关。因此临床应重视放射性损伤疼痛患者疼痛灾难化评估,积极干预以减轻患者疼痛,加强社会支持,从而降低放射性损伤疼痛患者疼痛灾难化水平。

Objective To investigate the status quo and influencing factors of pain catastrophizing in patients with radiationinduced injury pain to provide evidence for clinical prevention and intervention of it. Methods From June 2021 to January 2022, 115 patients with radiation-induced pain were enrolled in the First Affiliated Hospital of Zhengzhou University. A cross-sectional survey of patients was conducted using the General Data Questionnaire, Pain Catastrophizing Scale(PCS), Numerical Rating Scale(NRS), and Social Support Rating Scale(SSRS) to analyze the correlation between pain, social support, and pain catastrophizing levels. Multiple linear regression was used to analyze the influencing factors of pain catastrophizing in radiation-induced injuries. Results The total PCS score of 115 patients with radiation-induced pain was 21.13±3.75, in which the meditation dimension score was 4.52±2.87, the exaggeration dimension score was 4.59±3.41, and the helplessness dimension score was 11.74±7.45. The incidence rate of pain catastrophizing was 18.26% in patients. There were significant differences in PCS scores among patients with radiation-induced injury of different ages, radiotherapy sites, education levels, living style, duration of illness, type of radiation-induced injury, and grade of radiation-induced injury(P<0.05).Pearson correlation analysis showed that NRS score was positively correlated with PCS total score and contemplation, helplessness, and exaggeration dimension scores(r=0.418, 0.445, 0.450, and 0.370, all P<0.05). The SSRS score was negatively correlated with PCS total score and contemplation, helplessness, and exaggeration dimension scores(r=-0.339,-0.368,-0.411, and-0.359, all P<0.05). The multiple linear regression analysis showed that age, radiotherapy site, living style, duration of illness, type of radiation injury, and grade of radiation injury were all influencing factors of pain catastrophizing level in patients with radiation injury pain(P<0.05). Conclusion There are many influencing factors of pain catastrophizing level in patients with radiation-induced pain, and the degree of pain is positively correlated with the level of pain catastrophizing, and the level of social support is negatively correlated with the level of pain catastrophizing. Therefore, we should pay attention to the assessment of pain catastrophizing in patients with radiation-induced pain in clinical practice, actively intervene to reduce pain in patients, and strengthen social support, so as to reduce the level of pain catastrophizing in patients with radiation-induced pain.