Abstract

Objectives

There is a lack of knowledge on coping with pain and sub-group specific pain-coping profiles among older home care receivers with chronic pain. To describe pain-coping strategies, identify subgroups based on cognitive and behavioral pain-coping strategies and pain-related psychological impairment and to compare these groups with regard to socio-demographic, medical, pharmacological and psychological characteristics.

Method

Data of 212 care receivers were examined using the German pain-coping questionnaire (FESV) to determine how they cope with pain. Subgroups were identified using hierarchic agglomerative cluster analysis, using Ward’s algorithm and squared Euclidean distance, and characterized using socio-demographic, medical, pharmacological and psychological parameters. Multinomial logistic regression was used to identify variables associated with the subgroups.

Results

Older care receivers apply cognitive and behavioral strategies to manage pain. Three subgroups were identified: Cluster 1 (25.9%) with good coping competences and little psychological impairment, Cluster 2 (40.1%) with poor coping competences and high psychological impairment, and Cluster 3 (34%) with good coping competences and high psychological impairment. Significant differences between the clusters were observed for age, pain intensity, pain-related interference, daily activities, depression and resilience. Logistic regression demonstrated that belonging to Cluster 2 was associated with the number of pain-reducing medications, depression and resilience. Belonging to Cluster 3 was significantly linked to daily activities, the number of pain medications, depression and the level of care required.

Conclusion

Differentiating between pain-coping profiles in the group of older care receivers with chronic pain necessitates target group-specific pain-oriented psychotherapeutic interventions, which can result in improved pain management.

中文翻译：

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患有慢性疼痛的老年社区居住护理人员的疼痛应对类型

摘要

目标

在患有慢性疼痛的老年家庭护理人员中，缺乏应对疼痛和亚组特定疼痛应对概况的知识。为了描述疼痛应对策略，根据认知和行为疼痛应对策略以及与疼痛相关的心理障碍确定亚组，并比较这些组的社会人口、医学、药理学和心理特征。

方法

使用德国疼痛应对问卷 (FESV) 检查了 212 名护理人员的数据，以确定他们如何应对疼痛。使用分层凝聚聚类分析、使用 Ward 算法和平方欧几里得距离来确定亚组，并使用社会人口学、医学、药理学和心理参数进行表征。多项逻辑回归用于识别与亚组相关的变量。

结果

老年护理人员应用认知和行为策略来控制疼痛。确定了三个亚组：第 1 组 (25.9%) 具有良好的应对能力和轻微的心理障碍，第 2 组 (40.1%) 具有较差的应对能力和高度心理障碍，第 3 组 (34%) 具有良好的应对能力和高度心理障碍. 在年龄、疼痛强度、与疼痛相关的干扰、日常活动、抑郁和复原力方面观察到集群之间的显着差异。逻辑回归表明，属于第 2 类与减轻疼痛的药物、抑郁和恢复力的数量有关。属于第 3 组与日常活动、止痛药的数量、抑郁症和所需的护理水平显着相关。

结论

区分患有慢性疼痛的老年护理接受者群体的疼痛应对情况需要针对目标群体的疼痛导向心理治疗干预，这可以改善疼痛管理。