신경증 성향과 통증불안이 통증강도에 미치는 영향: 퇴행성 척추, 관절 질환 환자를 대상으로 = Influence of Neuroticism and Pain Anxiety on Pain intensity: A Study on Patients with Degenerative Spondylitis and Arthritis

국문 초록 (Abstract)

본 연구의 목적은 퇴행성 척추 질환 및 퇴행성 관절염 환자의 통증 강도가 신경증 성향과 통증불안에 의해 영향을 받는지 확인하고, 신경증 성향과 통증 불안의 하위 요인이 구체적으로 어떤경로를 통해 통증 강도에 영향을 미치는지 확인하는 것이었다. 변인 간 상관분석과 통증강도에대한 중다회귀분석 결과, 신경증 성향이 높고 통증 불안 수준이 높을수록 통증을 강하게 느끼는것으로 나타났다. 다음으로, 근골격계 만성통증환자의 통증 경험을 설명하는 공포-회피 모형(fear-avoidance model)을 근거로 신경증 성향과 통증 불안의 하위요인인 통증에 대한 두려운 생각, 생리적 각성, 통증 회피 행동이 통증 강도에 미치는 경로를 가정하여 경로분석을 수행하였다.
그 결과, 가정한 경로모형의 모형 적합도가 우수한 것으로 나타났다. 구체적으로 신경증 성향은통증에 대한 두려운 생각에 직접적으로 영향을 미치고, 통증에 대한 두려운 생각은 생리적 각성을 높이고, 회피 행동을 증가시켜 통증 강도에 영향을 주는 것으로 나타났다. 또한 신경증 성향은통증 불안의 하위 요인들을 매개로 통증 강도에 간접적으로 영향을 미치며, 통증에 대한 두려운생각은 생리적 각성과 회피 행동을 매개로 통증 강도에 간접적으로 영향을 미치며, 생리적 각성과 회피 행동은 각각 직접적으로 통증 강도에 영향을 미치는 것을 확인하였다. 마지막으로 본 연구의 의의와 제한점에 대해 논의하고 후속 연구를 위한 제언을 하였다.

다국어 초록 (Multilingual Abstract)

This study was to examine the influence of psychological factors, such as neuroticism and pain anxiety, on the pain intensity in patients with degenerative spondylitis and arthritis, and to further identify a pathway of the psychological influences on pain intensity. Correlation and multiple regression analysis revealed that patients who reported a higher level of neuroticism and pain anxiety were more likely to experience higher level of pain intensity. Based on the Fear-Avoidance Model, a path analysis was conducted to identify a possible pathway that illustrates the influences of neuroticism and sub-categories (e.g. fearful thoughts, physiological arousal, pain avoidance behavior) of pain anxiety, on pain intensity. Results demonstrate that the suggested pathway appropriatelyexplains the relationships. The pathway shows that neuroticism directly influences fearful thoughts about pain, which in turn increase the physiological arousal and pain avoidance behavior, and these influence the pain intensity.
Neuroticism also indirectly influences the pain intensity through sub-categories of pain anxiety. Fearful thoughts about pain have an indirect influence on pain intensity through physiological arousal and avoidance behavior. Physiological arousal directly influences the pain intensity. Lastly, we discuss the implications and limitations of this study, and suggestions for future research.

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