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| Title: | 老化態度與臨床慢性疼痛之關係—以「自覺老化-疼痛關聯性」為調節變項
The Relationship between Attitude toward Aging and Clinical Chronic Pain — “Subjective Aging-Pain Connection” as Moderator |
| Authors: | 龍奕薰
Long, Yi-Hsun |
| Contributors: | 吳治勳
Wu, Chih-Hsun
龍奕薰
Long, Yi-Hsun |
| Keywords: | 慢性疼痛
老年人
老化態度
疼痛接受度
疼痛自我效能
Chronic pain
Elderly
Attitude toward aging
Pain acceptance
Pain self-efficacy |
| Date: | 2021 |
| Issue Date: | 2021-08-04 15:38:04 (UTC+8) |
| Abstract: | 研究背景：慢性疼痛在老年族群中一直是非常普遍的臨床問題。老年慢性疼痛患者除了經驗疼痛之外，也同時在經歷自身逐漸老化的過程。雖疼痛不一定與患者身體上的老化/退化歷程有關，然而在整體社會環境訊息以及其經驗、認知的影響下，患者可能會將其疼痛狀況與老化連結在一起，而當患者主觀上因為慢性疼痛的相關刺激而意識到或認為自己「老了」，則可能促發其老化態度並影響後續的健康/疼痛狀態。本研究試圖探討中/老年慢性疼痛患者在看待其疼痛經驗時，老化態度對其疼痛情形可能之影響，以及「自覺疼痛—老化關聯性」在其中的調節作用，並檢驗年齡效果。
研究方法：本研究以北部某醫學中心之慢性疼痛患者為研究對象，利用疼痛評估與基本資料、「自覺疼痛—老化關聯性」題項、台灣老化態度量表（Taiwan Attitude toward Aging Questionnaire）、疼痛接受度量表（Chronic Pain Acceptance Questionnaire-revised）及疼痛自我效能量表（Pain Self-Efficacy Questionnaire）作為測量工具。以路徑分析探討「自覺疼痛—老化關聯性」是否調節老化態度（正/負老化自我覺知）與疼痛程度、疼痛接受度（活動參與、甘願疼痛）、及疼痛自我效能之間的關係。並以65、60、及50歲作為年齡切分點，探索不同年齡層之差異。
研究結果：路徑分析之參數預測結果顯示(1)「自覺疼痛—老化關聯性」低組：負向老化自我覺知可負向預測疼痛自我效能，正向老化自我覺知可正向預測活動參與和疼痛自我效能；(2)「自覺疼痛—老化關聯性」高組：負向老化自我覺知可負向預測活動參與和疼痛自我效能，正向老化自我覺知可負向預測疼痛程度，並正向預測活動參與和疼痛自我效能。(3)進一步檢驗「自覺疼痛—老化關聯性」在不同年齡層中是否有差異，結果顯示以不同年齡作為切分點時，各組呈現之預測效果不一致。
結論與討論：(1)本研究結果支持患者「自覺疼痛—老化關聯性」可調節老化態度對個人疼痛狀態之影響；此題項為一直觀、容易評估之工具，可應用於相關研究及臨床服務。(2)關聯性低時，正向老化自我覺知對於疼痛狀態的預測力較強；關聯性高時，負向老化自我覺知的預測力較強。(3)疼痛程度只有在患者認為疼痛與老化的關聯性高時，可被正向老化自我顯著預測(4)老化態度與疼痛狀態各變項可能有其各自影響的年齡層，然相互關係相當複雜尚無法釐清。未來研究應考慮除了疼痛門診以外更充足、來源更多元的樣本，以及加入更多針對主觀年齡、老化歷程、或情緒等方面的測量變項，以對患者「自覺疼痛—老化關聯性」有更深入的理解。
Background: Chronic pain has always been a common clinical problem in older people. In addition to pain, elderly patients with chronic pain were also experiencing their gradual aging process. Although the pain was not necessarily related to the patient`s physical degeneration process, patients might link their pain with aging under the influence of their own life experiences and social information. When patients subjectively recognized or assumed that they are "old" due to their chronic pain, it might elicit their "self-perception of aging (SPA)" and affect their health or pain subsequently. This study aimed to explore the influence of the SPA on pain in middle-aged and old-aged chronic pain patients and examine if "subjective pain-aging connection" and age could serve as moderators.
Methods: Chronic pain patients were recruited from pain clinics in a medical center in northern Taiwan. Participants were asked to fill the pain intensity scale, "Subjective Pain-Aging Connection" item, Taiwan Attitude toward Aging Questionnaire, Chronic Pain Acceptance Questionnaire-revised, Pain Self-Efficacy Questionnaire, and demographic variables. The path analysis model was used to explore whether "subjective pain-aging connection" moderated the relationship between self-perception of aging and pain intensity, pain acceptance, and pain self-efficacy. In addition, we used 65, 60, and 50 as age cut-off points to explore the differences in different age groups.
Results: The results of the parameter estimations showed that: (1) in the low "subjective pain-aging connection" group, negative SPA could negatively predict pain self-efficacy, and positive SPA could positively predict activity engagement and pain self-efficacy. (2) In the high "subjective pain-aging connection" group, negative SPA could negatively predict activity engagement and pain self-efficacy. Conversely, positive SPA could negatively predict pain intensity and positively predict activity engagement and pain self-efficacy. (3) The prediction effects presented by the age groups were inconsistent.
Discussion and conclusion: The results supported that the "subjective pain-aging connection" could moderate the relations between attitude toward aging and pain. This one-item tool was easy-to-assess and suitable for clinical use and research. The positive SPA has a more substantial predictive power for the pain status when the pain-aging connection is low. On the other hand, when the pain-aging connection is high, the negative self-perception of aging has a stronger predictive power. The pain intensity was an exception, it could be significantly predicted by positive SPA only when the patient`s "subjective pain-aging connection" was high. The relationships between SPAs and pain states were quite complicated in age groups and were hard to clarify. Further research should consider recruiting patients more diversely. In addition, adding more concepts of subjective age, personal experience of aging, or emotions could help to have a better and deeper understanding of the patient`s "subjective pain-aging connection." |
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行政院衛生福利部社會及家庭署（2020）：《老人福利法》。取自https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=D0050037
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| Description: | 碩士
國立政治大學
心理學系
106752007 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0106752007 |
| Data Type: | thesis |
| DOI: | 10.6814/NCCU202100783 |
| Appears in Collections: | [心理學系] 學位論文
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