口腔癌术前患者疼痛自我效能在经验性回避与疼痛的中介效应  

Mediating effect of pain self-efficacy between experiential avoidance and painseverity in patients with oral cancer

作　　者：黄修妤 苏汐锡 郑晓燕[3] 王荣娜 刘黄菊 郭语籁 高骥[1] HUANG Xiu-yu;SU Xi-xi;ZHENG Xiao-yan;WANG Rong-na;LIU Huang-ju;GUO Yu-lai;GAO Ji(School of Nursing,Fujian Medical University,Fuzhou 350122,China;Dept.of Gynecology,Fujian Cancer Hospital,Fuzhou 350014,China;Dept.of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Dept.of Otorhinolaryngology Head and Neck Surgery,Air Force Medical University,Xi’an 710000,China)

机构地区：[1]福建医科大学护理学院,福建福州350122 [2]福建省肿瘤医院妇科,福建福州350014 [3]福建医科大学附属第一医院口腔颌面外科,福建福州350005 [4]空军军医大学第一附属医院耳鼻咽喉头颈外科,陕西西安710000

出　　处：《护理学报》2023年第15期64-68,共5页Journal of Nursing（China）

基　　金：福建省自然科学基金(2020J01643)。

摘　　要：目的 探讨疼痛自我效能在口腔癌术前患者经验性回避与疼痛间的中介作用。方法 便利抽样法选取2021年2月—2022年8月福建省某三级甲等综合性医院住院的206例口腔癌术前患者为研究对象。采用一般资料调查表、疼痛自我效能量表、中文版接纳与行动问卷和疼痛视觉模拟评分表进行调查,构建并检验中介模型。结果 口腔癌术前患者经验性回避总分、疼痛自我效能总分和疼痛得分分别为(22.86±9.12)分、(40.79±13.63)分、(4.23±1.94)分。经验性回避对疼痛有直接正向预测作用(β=0.034,P=0.042),经验性回避对疼痛自我效能有直接负向预测作用(β=-0.884,P<0.001),疼痛自我效能对疼痛有直接负向预测作用(β=-0.049,P<0.001),疼痛自我效能在经验性回避与疼痛之间起部分中介作用,中介效应占55.84%。结论 口腔癌术前患者疼痛处于中等水平,经验性回避总分处于中等偏下水平,疼痛自我效能总分处于中等偏上水平,经验性回避和疼痛自我效能与患者疼痛密切相关。建议医护人员指导患者不要刻意压抑或逃避疼痛,并重视患者疼痛自我效能感的提高,以促进疼痛缓解。Objective To explore the mediating effect of pain self-efficacy between experiential avoidance and pain severity in patients with oral cancer before surgery.Methods A total of 206 patients who were hospitalized in a comprehensive tertiary grade-A hospital in Fujian Province were selected from February 2021 to August 2022.The general information questionnaire,Pain Self-Efficacy Questionnaire,Chinese version of Acceptance and Action Questionnaire and Visual Analogue Scale were used.Results The score of experiential avoidance,pain self-efficacy and pain severity in patients with oral cancer was 22.86±9.12,40.79±13.63 and 4.23±1.94 respectively.Experiential avoidance had a direct effect on pain level(β=0.034,P=0.042),and pain self-efficacy(β=-0.884,P<0.001),and pain self-efficacy had a direct negative effect on pain level(β=-0.049,P<0.001).Pain self-efficacy partially mediated the relationship between experiential avoidance and pain severity,which accounted for 55.84%of the total effect.Conclusion Preoperative pain severity of patients with oral cancer is in the medium level,and the total score of experiential avoidance,and pain self-efficacy is in lower middle and upper middle level respectively.No deliberate control or avoid of pain,and more attention to the improvement of patients’pain self-efficacy are conducive to promoting pain relief.

关 键 词：术前 口腔癌 经验性回避 疼痛自我效能 疼痛 

分 类 号：R473.73[医药卫生—护理学]