Research On The Current Status And Influencing Factors Of Pain Catastrophe In Orthopedic Chronic Pain Patients In Dali Region

ObjectiveTo clarify the current situation of pain catastrophizing in orthopedic chronic pain patients,comprehensively explore pain catastrophizing and the influencing factors of each dimension,and provide a basis for preventing and reducing the level of pain catastrophizing and taking active and effective interventions.Methods1.Quantitative study: 400 chronic pain patients in orthopedic departments of two tertiary care hospitals in Dali Bai Autonomous Prefecture,Yunnan Province,between February and November 2022 were selected as study subjects,and the General Information Questionnaire,Pain Catastrophizing Scale(PCS),Comprehensive Hospital Anxiety and Depression Scale(HADS),Positive Negative Affect Scale(PANAS),Family Caring Index Questionnaire(APGAR),and Satisfaction with Life Scale(SWLS)were administered.excel 2019 was used to enter the data,and data were analyzed using SPSS 20.0,using descriptive statistical analysis,one-way analysis,correlation analysis,and multiple linear regression analysis to explore the factors influencing pain catastrophizing.2.Qualitative study:15 chronic pain patients with pain catastrophizing were interviewed using a phenomenological,semi-structured interview method,and the data were analyzed using NVivo 11.0 software combined with Colaizzi phenomenology.Results1.A pain catastrophizing level was reached by a score of ≥38 on the Pain Catastrophizing Scale,and 129 cases in this study reached the pain catastrophizing level,with an incidence of 32.0%.2.Patients with chronic pain had a pain catastrophizing score of(36.23±11.67),with a mean entry score of(2.79±0.89),a regurgitation dimension score of(11.26±3.82);an exaggeration dimension score of(8.42±2.76);and a helplessness dimension score of(17.11±5.54).3.Univariate analysis results of disease diagnosis,pain level,positive emotions,negative emotions,anxiety,depression,life satisfaction,and family functioning were associated with pain catastrophizing(p < 0.05).4.Pearson correlation analysis showed that positive mood,life satisfaction and family functioning were negatively correlated with pain catastrophizing score(r=-0.79,p<0.01),(r=-0.76,p<0.01),(r=-0.75,p<0.01);pain level,negative mood,anxiety and depression were positively correlated with pain catastrophizing score(r=0.88,p<0.01),(r=0.85,p<0.01),(r=0.73,p<0.01),(r=0.72,p<0.01).5.Results of multifactorial analysis: pain level,negative emotions,life satisfaction,and family functioning scores entered the pain catastrophizing regression equation and together explained 84.1%(p < 0.01)of the total variance in pain catastrophizing.6.Pain catastrophizing patient experience was grouped into 5 themes: profound pain experience,unpromising pain management status,ineffective pain management,high disease burden,and inadequate exogenous support systems.Conclusion1.Orthopedic chronic pain patients have a high incidence of pain catastrophizing,which is mainly manifested as helplessness after failing to cope with pain.2.Pain level,negative emotions,life satisfaction and family functioning are the main influencing factors for the occurrence of pain catastrophizing.3.Preventing and reducing the occurrence of pain catastrophizing can be implemented in the following five aspects: attaching importance to patients’ pain experience and paying attention to their pain;improving pain management based on assessment and treatment;regulating negative emotions,deepening health education,and improving patients’ awareness of pain self-management;strengthening family support;and appropriately increasing the financial investment or restructuring of residents’ health insurance.