پیش‌بینی ناتوانی کارکردی بر اساس سبک زندگی ارتقا دهنده سلامت، پریشانی روانشناختی، سازگاری هیجانی با نقش میانجی اجتناب تجربه‌ای در بیماران مبتلا به درد مزمن

هاشمی, سارا; قلیزاده, ریحانه

doi:10.22034/jmpr.2023.57111.5656

پیش‌بینی ناتوانی کارکردی بر اساس سبک زندگی ارتقا دهنده سلامت، پریشانی روانشناختی، سازگاری هیجانی با نقش میانجی اجتناب تجربه‌ای در بیماران مبتلا به درد مزمن

نوع مقاله : مقاله پژوهشی

نویسندگان

¹ استادیار، گروه روانشناسی بالینی، دانشکده علوم و فناوری های پزشکی، واحد علوم تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران.

² دانشجوی ارشد روانشناسی بالینی، دانشکده علوم و فناوری های پزشکی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران.

10.22034/jmpr.2023.57111.5656

چکیده

درد مزمن از بیماری‌های مزمن با سرعت گسترش بالا در جهان است. می‌تواند علت یا معلول طیف گسترده‌ای از علایم روانشناختی بیماران باشد. هدف این پژوهش پیش‌بینی ناتوانی کارکردی براساس سبک زندگی ارتقا دهنده سلامت، پریشانی‌روانشناختی، سازگاری هیجانی با نقش میانجی اجتناب تجربه‌ای در بیماران دچار درد مزمن است.پژوهش حاضر توصیفی_همبستگی است، جامعه آماری آن شامل کلیه بیمارانی است که با تشخیص درد مزمن به مرکز روماتیسم ایران و بیمارستان فرهیختگان در نیمه اول سال 1401 مراجعه کردند. روش نمونه گیری هدفمند و با در نظر گرفتن ملاک‌های ورود و خروج 130 نفر انتخاب شدند. به منظور گردآوری داده‌ها از پرسشنامه‌های خود ناتوان‌سازی جونز و رودوالت، سبک زندگی ارتقا دهنده سلامت والکر و همکاران، پریشانی روا‌نشناختی کسلر و همکاران، سازگاری هیجانی رابیو و همکاران، پذیرش و عمل باند و همکاران استفاده شده است. داده‌های جمع‌آوری شده در سطوح توصیفی و استنباطی و مدل پژوهش با استفاده از تکنیک تحلیل مسیر ارزیابی شد.رابطه معنی داری بین تمامی متغیرهای پیش بین و اجتناب تجربه‌ای با متغیر ناتوانی کارکردی برقرار است (0/05>p). همبستگی معنی‌داری بین متغیرهای مستقل پریشانی روان‌شناختی و سازگاری هیجانی با متغیر میانجی اجتناب تجربه‌ای مشاهده شد (0/05>p)، نقش میانجی اجتناب تجربه‌ای در رابطه بین سازگاری هیجانی و ناتوانی کارکردی تایید شد (0/05>p). نقش میانجی اجتناب تجربه‌ای در رابطه بین سبک زندگی ارتقادهنده سلامت و پریشانی روانشناختی با ناتوانی کارکردی تایید نشد (0/05<p). یافته‌های پژوهش همسو با مدل‌های پژوهش است. بر اساس یافته‌های به دست آمده می‌توان بیان کرد، ناتوانی کارکردی در طی زندگی با درد در بیماران ایجاد می‌گردد و به وسیله سایر متغیرهای روانشناختی مذکور می‎‌توان بر شدت ناتوانی تاثیر گذاشت.

کلیدواژه‌ها

موضوعات

روانشناسی

عنوان مقاله [English]

Prediction of Functional Disability Based on Health-Promoting Lifestyle, Psychological Distress, Emotional Adjustment with Mediating Role of Experiential Avoidance in Patients with Chronic Pain

نویسندگان [English]

Sara Hashemi ¹
Reyhaneh Gholizadeh ²

¹ Assistant Professor, Department of Clinical Psychology, Faculty of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran, Iran.

² M.A. in Clinical Psychology, Faculty of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran, Iran.

چکیده [English]

Chronic pain is a rapidly growing chronic condition worldwide which can be the cause or effect of a wide range of psychological symptoms of patients. The aim of this research is to predict functional disability based on health-promoting lifestyle, psychological distress, and emotional adjustment with the mediating role of experiential avoidance in patients with chronic pain. The present research is of descriptive-correlational type. The statistical population consists of all patients referring to Iran’s Rheumatology Center and Farhikhtegan Hospital in April-September 2022 with the diagnosis of chronic pain. Sampling method was purposive, whereby considering the inclusion and exclusion criteria, 130 subjects were chosen. For data collection, Jones & Rudwalt self-handicapping, Walker’s et al. health-promoting lifestyle, Kessler et al. psychological distress, Rubio et al. emotional adjustment, Bond et al. acceptance and action scales have been used. The collected data were analyzed at descriptive and inferential levels, with the research model evaluated using path analysis technique. A significant relationship was found between all predictor variables, as well as experiential avoidance and functional disability (P<0.05). A significant correlation was also found between the independent variables of psychological distress, emotional adjustment and experiential avoidance as intervening variable (P<0.05). The mediating role of experiential avoidance in the relationship between emotional adjustment and functional disability was confirmed (P<0.05). No significant association was observed between health-promoting lifestyle, psychological distress and experiential avoidance (P>0.05). The research findings have been in line with the research models. Based on the obtained results, it can be stated that functional disability along the life span occurs with pain in patients, and the intensity of disability can be affected by other mentioned psychological variables.

کلیدواژه‌ها [English]

chronic pain
emotional adjustment
experiential avoidance
functional disability
health-promoting lifestyle
psychological distress

مراجع

اصغری مقدم، محمدعلی. (1394). درد و سنجش آن. تهران: انتشارات رشد.

بهبهانی مندنی‌زاده, آناهید؛ همائی, رضوان. (1399). رابطه علی انگ ناباروری و پریشانی روانشناختی با کیفیت رابطه زناشویی از طریق میانجی گری فراهیجان در زنان نابارور. خانواده پژوهی. 16(1)؛ 55-76.

شکری، امید، سنایی پور، محمدحسین، رویایی، زهرا، و قره تپه ای، زهرا. (1395). ویژگی های روان سنجی مقیاس سازگاری هیجانی در دانشجویان ایرانی. اندازه‌گیری تربیتی، 6(23)، 77-97. SID. https://sid.ir/paper/214553/fa

Abasi, E., Fti, L., Molodi, R., & Zarabi, H. (2012). Psychometric properties of Persian version of acceptance and action questionnaire–II. Psychological Methods and Models, 3(10/Winter 2013), 65-80.

Andrews, G., & Slade, T. (2001). Interpreting scores on the Kessler psychological distress scale (K10). Australian and New Zealand journal of public health, 25(6), 494-497.

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K.,... & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior therapy, 42(4), 676-688.

Campbell, C. M., Jamison, R. N., & Edwards, R. R. (2013). Psychological screening/phenotyping as predictors for spinal cord stimulation. Current pain and headache reports, 17, 1-8.

Chen, Y. F., Huang, X. Y., Chien, C. H., & Cheng, J. F. (2017). The effectiveness of diaphragmatic breathing relaxation training for reducing anxiety. Perspectives in psychiatric care, 53(4), 329-336.

Choi, N. G., Sullivan, J. E., DiNitto, D. M., & Kunik, M. E. (2019). Associations between psychological distress and health-related behaviors among adults with chronic kidney disease. Preventive medicine, 126, 105749.

Costa, J., & Pinto‐Gouveia, J. (2013). Experiential avoidance and self‐compassion in chronic pain. Journal of Applied Social Psychology, 43(8), 1578-1591.

Crombez, G., Eccleston, C., De Vlieger, P., Van Damme, S., & De Clercq, A. (2008). Is it better to have controlled and lost than never to have controlled at all? An experimental investigation of control over pain. PAIN, 137(3), 631-639.

Currie, H., Abernethy, K., Gray, S., & British Menopause Society Medical Advisory Council. (2017). British Menopause Society vision for menopause care in the UK: Endorsed by Royal College of General Practitioners, Faculty of Sexual and Reproductive Health, Royal College of Nursing, and Royal College of Obstetricians and Gynaecologists. Post Reproductive Health, 23(3), 105-109.

Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., ... & Helmick, C. (2018). Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016. Morbidity and Mortality Weekly Report, 67(36), 1001.

Delavar, A. (2015). Studding the psychometric properties of self-handicapping scale. Quarterly of Educational Measurement, 5(20), 97-117.

Demir, S. (2018). Multiple sclerosis functional composite. Archives of Neuropsychiatry, 55(Suppl 1), S66.

Feeney, J. (2012). Physical disability and psychological distress in multiple sclerosis: the role of illness representations and experiential avoidance (Doctoral dissertation, Cardiff University).

Goodwin, C. L., & Emery, C. F. (2016). Lower experiential avoidance is associated with psychological well-being and improved cardiopulmonary endurance among patients in cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 36(6), 438-444.

Greenwood-Van Meerveld, B., & Johnson, A. C. (2018). Mechanisms of stress-induced visceral pain. Journal of neurogastroenterology and motility, 24(1), 7.

Gyasi, R. M. (2019). Social support, physical activity and psychological distress among community-dwelling older Ghanaians. Archives of gerontology and geriatrics, 81, 142-148.

Hajhashemkhani, M. A., Dalvandi, A., Kashaninia, Z., Javadi, M., & Biglarian, A. (2015). The relationship between family health promoting lifestyle and sleep habits in children 6 to 11 years old. Journal of Mazandaran University of Medical Sciences, 25(127), 92-99.

Hershenberg, R., Mavandadi, S., Wright, E., & Thase, M. E. (2017). Anhedonia in the daily lives of depressed veterans: A pilot report on experiential avoidance as a moderator of emotional reactivity. Journal of affective disorders, 208, 414-417.

Huard, P. (2018). The Management of Chronic Diseases: Organizational Innovation and Efficiency. Hoboken: John Wiley & Sons.

International Association for the Study of Pain. (2012). Unrelieved pain is a major global healthcare problem.

Izadi, A., Sepahvand, F., Naderifar, M., & Mohammadipour, F. (2013). The Effect of an Educational Intervention on Quality of Life in Patients with Type 2 Diabetes Referring to Tamin Ejtemaei Hospital in 2013. Journal of Diabetes Nursing, 2, 18-28.

Jones, G., Winzenberg, T. M., Callisaya, M. L., & Laslett, L. L. (2014). Lifestyle modifications to improve musculoskeletal and bone health and reduce disability–A life-course approach. Best Practice & Research Clinical Rheumatology, 28(3), 461-478.

Karademas, E. C., Karekla, M., Flouri, M., Vasiliou, V. S., Kasinopoulos, O., & Papacostas, S. S. (2017). The impact of experiential avoidance on the relations between illness representations, pain catastrophising and pain interference in chronic pain. Psychology & Health, 32(12), 1469-1484.

Kelso, K. C., Kashdan, T. B., Imamoğlu, A., & Ashraf, A. (2020). Meaning in life buffers the impact of experiential avoidance on anxiety. Journal of Contextual Behavioral Science, 16, 192-198.

Leung, Y. S., Lee, J. J. W., Lai, M. M. P., Kwok, C. K. M., & Chong, K. C. (2020). Association between obesity, common chronic diseases and health promoting lifestyle profiles in Hong Kong adults: a cross-sectional study. BMC public health, 20, 1-9.

Luck, B. (2015). Individual Differences in Job Satisfaction. Journal of Organizational Behaviors, 16(1), 109-115.

Major, D. H., Røe, Y., Småstuen, M. C., van der Windt, D., Sandbakk, T. B., Jæger, M., & Grotle, M. (2022). Fear of movement and emotional distress as prognostic factors for disability in patients with shoulder pain: a prospective cohort study. BMC Musculoskeletal Disorders, 23(1), 183.

Martin, K. A., & Brawley, L. R. (1999). Is the self-handicapping scale reliable in non-academic achievement domains?. Personality and individual Differences, 27(5), 901-911.

Mehta, S., Rice, D., Janzen, S., Pope, J. E., Harth, M., Shapiro, A. P., & Teasell, R. W. (2016). Mood, Disability, and Quality of Life among a Subgroup of Rheumatoid Arthritis Individuals with Experiential Avoidance and Anxiety Sensitivity. Pain research & management, 2016, 7241856.

Mirghafourvand, M., Baheiraei, A., Nedjat, S., Mohammadi, E., Charandabi, S. M. A., & Majdzadeh, R. (2015). A population-based study of health-promoting behaviors and their predictors in Iranian women of reproductive age. Health promotion international, 30(3), 586-594.

MOGHADAM, F., & NAMVAR, H. (2020). The Roles of Lifestyle and Psychological Disturbance in Functional Disability of Patients with Breast Cancer. JOURNAL OF ASSESSMENT AND RESEARCH IN COUNSELING AND PSYCHOLOGY, 2(1(3)), 19-34. SID. https://sid.ir/paper/363995/en

Mohamadi, H., Jabalameli, S., Haghayegh, S. A., & Ranjbarkohan, Z. (2021). Structural Model of the Effect of Health Promoting Lifestyle and Distress Tolerance on Chronic Pain Acceptance in Patients with Chronic Musculoskeletal pain: Study of the Mediating Role of Learned Helplessness. Anesthesiology and Pain, 12(3), 35-49.

Mohammadi Zeidi, I., Pakpour Hajiagha, A., & Mohammadi Zeidi, B. (2011). Reliability and validity of Persian version of the health-promoting lifestyle profile. Journal of Mazandaran University of Medical Sciences, 20(1), 102-113.

Murdaugh, C. L., Parsons, M. A., Pender, N. J. (2006). Health Promotion in Nursing Practice. United Kingdom: Prentice Hall.

Murray, C. J., Abraham, J., Ali, M. K., Alvarado, M., Atkinson, C., Baddour, L. M., & Lopez, A. D. (2013). The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. Jama, 310(6), 591-606.

Naylor, M. R., Krauthamer, G. M., Naud, S., Keefe, F. J., & Helzer, J. E. (2011). Predictive relationships between chronic pain and negative emotions: a 4-month daily process study using Therapeutic Interactive Voice Response (TIVR). Comprehensive psychiatry, 52(6), 731-736.

Nelson, S., Conroy, C., & Logan, D. (2019). The biopsychosocial model of pain in the context of pediatric burn injuries. European journal of pain, 23(3), 421-434.

Profis, M., & Simon-Tuval, T. (2016). The influence of healthcare workers’ occupation on Health Promoting Lifestyle Profile. Industrial health, 54(5), 439-447.

Rubio, V. J, Aguado, D., Hontangas, P. M., & Hernández, J. M. (2007). Psychometric properties of an emotional adjustment measure: An application of the graded response model. European Journal of Psychological Assessment, 23(1), 39-46.

Shamji, M. F, Rodriguez, J, Shcharinsky, A., & Paul, D. (2016). High rates of undiagnosed psychological distress exist in a referral population for spinal cord stimulation in the management of chronic pain. Neuromodulation: Technology at the Neural Interface, 19(4), 414-421.

Sharpe, L., & Curran, L. (2006). Understanding the process of adjustment to illness. Social science & medicine, 62(5), 1153-1166.

St Sauver, J. L, Warner, D. O., Yawn, B. P., Jacobson, D. J., McGree, M. E., Pankratz, J. J., Melton, L. J, 3rd, Roger, V. L, Ebbert, J.O, & Rocca, W. A. (2013). Why patients visit their doctors: assessing the most prevalent conditions in a defined American population. Mayo Clinic proceedings, 88(1),56-67.

Tabachnick, B. G., & Fidell, L. S. (2007). Using Multivariate Statistics (5th ed.). New York: Allyn and Bacon

Teasdale, T. W., & Antal, K. (2016). Psychological distress and intelligence in young men. Personality and Individual Differences, 99, 336-339.

Treede, R. D, Rief, W., Barke, A., Aziz, Q, Bennett, M. I., Benoliel, R, ... & Wang, S. J. (2015). A classification of chronic pain for ICD-11. Pain, 156(6), 1003.

Trucharte, A., Leon, L., Castillo-Parra, G., Magán, I., Freites, D., & Redondo, M. (2020). Emotional regulation processes: influence on pain and disability in fibromyalgia patients. Clin Exp Rheumatol, 38(Suppl 123), 40-6.

Vaziri, S., & LOtfi Kashani, F. (2013). Study of factor structure, reliability and validity of the sexual self efficacy questionnaire. Thoughts and Behavior in Clinical Psychology, 8(29), 47-56.

Walker, S, & Hill-Polerecky, D. M. (1997). Psychometric evaluation of health promoting lifestyle profile II. Lincoln. Unpublished manuscript, University of Nebraska Medical Center, College of Nursing.

Walker, S. N, Sechrist, K. R, & Pender, N. J. (1987). The health-promoting lifestyle profile: development and psychometric characteristics. Nursing research, 36(2), 76-81.