Social support for functional dependence, activity patterns, and chronic pain outcomes: A cross-lagged mediation panel study.

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-07-01 Epub Date: 2024-03-21 DOI:10.1037/hea0001370

Sónia F Bernardes, Tânia Brandão, Marta Osório de Matos, Alexandra Ferreira-Valente

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Abstract

Objective: Received social support undermining engagement in life activities of individuals with chronic pain (e.g., solicitousness, support for functional dependence) is consistently correlated with worse physical functioning, pain severity, and disability. Whether such responses lead to worse pain outcomes (operant model of pain) or the latter lead to more supportive responses undermining activity engagement (social communication and empathy models of pain) is unknown, given the lack of cross-lagged panel studies. Furthermore, the mediating role of activity patterns in such relationships over time is entirely unclear. This study aimed to bridge these gaps.

Method: This was a 3-month prospective study with three waves of data collection (T1-T3; 6-week lag in-between), including 130 older adults (71% women; M_age = 78.26) with musculoskeletal chronic pain attending day-care centers. At every time point, participants filled out self-report measures of staff social support for functional dependence, activity patterns, physical functioning, pain severity, and interference. Scales showed good/very good test-retest reliability (ICC = .74-.96) and internal consistency (all α > .90).

Results: Parsimonious cross-lagged panel mediation models showed the best fit (χ²/df < 2.44; CFI > .96; GFI > .93; RMSEA < .09). Bidirectional effects were found over time, but poorer pain outcomes at T1 (higher pain severity/interference, lower physical functioning) more consistently predicted higher social support for functional dependence than vice versa. Poorer pain outcomes (T1) predicted more avoidance/less overdoing (T3), via increased received support for functional dependence (T2).

Conclusion: Further research on the cyclical relationships between the study variables across chronic pain trajectories is needed to harness the power of interpersonal relationships in future self-management interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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对功能依赖、活动模式和慢性疼痛结果的社会支持：交叉滞后调解面板研究。

目的：慢性疼痛患者所接受的社会支持（如征求意见、对功能依赖的支持）会影响其参与生活活动的程度，这与身体功能、疼痛严重程度和残疾程度的恶化一直相关。由于缺乏跨滞后的面板研究，我们还不知道这些支持是否会导致更糟糕的疼痛结果（疼痛的操作性模型），或者后者是否会导致更多的支持性反应，从而影响活动参与（疼痛的社会沟通和移情模型）。此外，活动模式在这种时间关系中的中介作用也完全不清楚。本研究旨在填补这些空白：这是一项为期 3 个月的前瞻性研究，共收集了三波数据（T1-T3；中间滞后 6 周），包括 130 名在日托中心接受治疗的患有肌肉骨骼慢性疼痛的老年人（71% 为女性；Mage = 78.26）。在每个时间点，参与者都填写了关于工作人员对功能依赖、活动模式、身体功能、疼痛严重程度和干扰的社会支持的自我报告测量。量表显示出良好/非常良好的测试-重测可靠性（ICC = .74-.96）和内部一致性（所有α均大于.90）：拟合的交叉滞后面板中介模型显示出最佳拟合效果（χ²/df < 2.44；CFI > .96；GFI > .93；RMSEA < .09）。随着时间的推移，发现了双向效应，但在 T1 阶段，较差的疼痛结果（较高的疼痛严重程度/干扰、较低的身体功能）更能预测较高的功能依赖社会支持，反之亦然。较差的疼痛结果（T1）预示着更多的回避/更少的过度行为（T3），通过增加对功能依赖的社会支持（T2）来实现：结论：需要进一步研究慢性疼痛轨迹中研究变量之间的周期性关系，以便在未来的自我管理干预中利用人际关系的力量。(PsycInfo Database Record (c) 2024 APA，保留所有权利）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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