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Investigation the Status of Emotion, Quality of Life and Evaluation the Effect of Intervention in Chronic Pain Patients

Author: ChenGuoLiang
Tutor: CuiHong
Course: Neurology
Keywords: Chronic pain Anxiety Depression Quality of sleepChronic pain attentional bias ERPChronic pain Quality of life InsomniaChronic pain Relaxation training Insomnia
CLC: R749.4
Type: Master's thesis
Year: 2013
Downloads: 112
Quote: 0
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Part Ⅰ:Study on Anxiety Depression and Quality of sleepof Patients with chronic painObjective: The purpose of this study is to investigate the prevalence and the relevantfactors of psychological problems of patients with chronic pain. Methods: Since August toDecember2012, we used questionnaires to investigate the psychological status of308patients with chronic pain. The questionnaires include Short Form McGill PainQuestionnaire (SF-MPQ), Hospital anxiety and depression scale (HAD), Pittsburgh SleepQuality Index (PSQI). Results: Recycling of301valid questionnaires has97.93percentefficiency.106patients (35.22%) had symptoms of anxiety and83patients (27.57%) hadsymptoms of depression. There were57patients (18.94%), who had two kinds ofsymptoms at the same time.137patients(45.51%)had symptoms of insomnia. Theincidence of anxiety and depression were no correlated with gender, age, education,occupation, Marital status and Duration of pain(p>0.05), but The incidence of anxietyand depression were correlated with Present Pain Intensity(p<0.01), the number of painlocation(p<0.05), the number of emotional count and feeling count(p<0.01).Multivariate regression analysis found the incidence of anxiety and depression in chronicpain patients were related to Present Pain Intensity (p<0.05) and the number of emotionalcount (p<0.001). The quality of sleep is related to Present Pain Intensity(p<0.01)andWhether associated with anxiety and depression(p<0.001). Conclusions: The depression,anxiety and insomnia of the chronic pain patients was significantly higher prevalence,andrelated to multiple factors. Part Ⅱ:Attentional biases in chronic pain patients: An ERP studyObjective: To explore the attentional biases towards pain-related words in chronic painpatients. Methods: Sixteen chronic pain patients and16matched controls performed a computer version of emotional stroop task. Compared the reaction time (RT) and correctrate under3conditions (neutral, pain-related and threat words).The ERPs of32channelswere recorded in both groups.Results: Chronic pain patients’ RT under the pain-relatedwords and threat words was longer than the neutral words. The control group’s RT to threatinformation was longer than the neutral words. The threat information induced greaterP200in both groups, pain-related words evoked greater P300in chronic pain patients;Conclusions: Chronic pain show attentional bias to pain-related information, It’s mayberelated to emotional control process; Both groups show attentional bias to threatinformation, it’s maybe related to emotional automatic process. Part Ⅲ: The study on quality of life and its influential factors in chronic painpatientsObjective: To investigate the quality of life and its influential factors in chronic painpatients. Method:301chronic pain patients were participated in the study. The paincharacteristics, quality of life, depression, anxiety, insomnia were evaluated respectively byusing the Chinese version of short form McGill Pain Questionnaire(SF-MPQ), Quality ofLife Index(QL-index), Hospital anxiety and depression scale(HAD), Pittsburgh SleepQuality Index(PSQI). Student’s t test, analysis of variance, Pearson correlation analysis,multiple linear stepwise regression analysis was used in the data analysis. Result:①Thequality of life in chronic pain patients without anxiety is significantly higher than thosewith anxiety(p<0.001); The quality of life in chronic pain patients without depression wassignificantly higher than those with depression(p<0.001); The quality of life in chronicpain patients without insomnia was significantly higher than those with insomnia (p<0.001);②The quality of life in Severe pain patients was significantly lower than those inmild to moderate pain(p<0.001).③QL-Index total score was negatively correlated withSF-MPQ total score and SF-MPQ sensory pain sub-score, emotional pain sub-score,VASsub-score, PPI sub-score, the number of emotional count and feeling count, HAD(a),HAD(d), PSQI total score (r=-0.195-0.433, p<0.01).The multiple linear stepwiseregression analysis models predicted a total of49.1%of the variance of QL-Index totalscore in chronic pain patients. The independent variables that had a significant influence onQL-Index total score were emotional pain sub-score, HAD (d), VAS sub-score, emotional pain sub-score was the most obvious influential factor.Conclusion: Anxiety, Depression,Insomnia, The pain characteristics (Present Pain Intensity, the number of emotional countand feeling count) significantly affected the quality of life in chronic pain patients. Part Ⅳ: Effect of relaxation training on anxiety, depression and quality of sleep forchronic pain patientsObjective: The purpose of this study is to assess relaxation training on anxiety, depression,and quality of sleep in chronic pain patients. Methods: In this study,70chronic painpatients who were experiencing anxiety and depression were randomly assigned to twogroups: intervention group and control group, which group contains35patients. Therewere2cases dropout in intervention group and5cases dropout in control group. Allchronic pain patients received conventional therapy while the patients in interventiongroup were given relaxation training..Results: The score of anxiety depression and sleepquality were declined after1week treatment in both of two groups. the interventiongroup’s anxiety depression and sleep quanlity score is lower than the control group.Analysis of variance of repeated measures indicated that anxiety depression and quality ofsleep had significant difference among difference intervention time(P<0.01). Theintervention group was significant positive changes occurred for anxiety, depression andquality of sleep after two weeks and4weeks treatment(p<0.01). However the controlgroup was no significant improvement for anxiety, depression and quality of sleep after2weeks and4weeks treatment(p>0.05). Conclusion: relaxation training is beneficial toalleviate anxiety, depression, improve quality of sleep in chronic pain patients.

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