Razi Journal of Medical Sciences

fa بررسی نقش واسطه‌ای تنظیم هیجان در رابطه بین منبع کنترل و شدت درد در بیماران مبتلا به درد مزمن Investigating the Mediating Role of Emotion Regulation in the Relationship between Locus of Control and Pain Intensity in Chronic Pain Patients روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: شواهد نشان میدهد که تنظیم هیجان در سازگاری طولانی مدت با اختلال درد نقش کلیدی ایفا میکند. پژوهش حاضر جهت بررسی نقش واسطهای تنظیم هیجان در رابطه بین منبع کنترل و شدت درد در افراد مبتلا به درد مزمن انجام شد. روش کار: روش پژوهش حاضر، توصیفی و از نوع همبستگی میباشد. جامعه آماری این پژوهش کلیه بیماران مبتلا به درد مزمن شهر اسفراین در سال 1398 بود. نمونه  شامل  200 بیمار مبتلا به درد مزمن 25 تا 45 ساله بود که به روش نمونهگیری در دسترس از بیمارستان امام خمینی، کلینیک تخصصی علوم پزشکی و مراکز سلامت شهید شکوهی، شهید منتظری و امام رضا (ع) انتخاب شدند. پرسشنامه کوتاه درد، منبع کنترل سلامت و تنظیم هیجان به عنوان ابزارهای پژوهش استفاده شد. برای تحلیل یافتهها از آزمون همبستگی، تحلیل رگرسیون و تحلیل مسیر استفاده شد. دادهها با استفاده از نرمافزار SPSS-23 مورد تجزیه و تحلیل قرار گرفتند. یافته ها: بر اساس یافتهها، نقش واسطهای تنظیم هیجان (ارزیابی مجدد – سرکوب) در رابطه بین منبع کنترل درونی و شدت درد تایید شد. به این صورت که افرادی که دارای منبع کنترل درونی بودند، بیشتر از راهبرد سازگارانه ارزیابی مجدد و کمتر از راهبرد ناسازگارانه سرکوبی استفاده میکردند و به تبع آن شدت درد کمتری را تجربه کردند. علاوه بر این؛ در این پژوهش نقش واسطهای تنظیم هیجان (ارزیابی مجدد- سرکوبی) در رابطه بین منبع کنترل بیرونی و شدت درد نیز تایید شد. طبق این یافته، افرادی که از منبع کنترل بیرونی برخوردار بودند، بیشتر از راهبرد ناسازگارانه سرکوب استفاده میکردند و در نتیجه شدت درد بیشتری را تجربه کردند. نتیجه گیری: اگر در کنار برنامه درمانی این بیماران آموزش راهبردهای تنظیم هیجان در دستور کار قرار گیرد، میتوان به کاهش شدت درد این بیماران کمک کرد.</div> <div style="text-align: justify;">Background & Aims: Chronic pain is used to describe non-cancerous and refractory pain (1). Chronic pain is a pain that has continued every day for at least three months for the past six months (5). This pain affects the quality of life, so it is necessary to identify and pay attention to the role of chronic pain in mental and physical health. Psychological factors are indirectly related to the process of pain perception. As pain becomes more chronic, the role of psychological factors in the spread and persistence of pain becomes more prominent than the role of biological factors. In this regard, researchers have emphasized the importance of the locus of control (7). Belief in the extent to which a person controls their circumstances, behavior, and thoughts can be considered a factor in determining the severity of pain (8). Numerous psychosocial factors can affect the severity of pain. Studies have shown that emotion regulation and its components directly affect the intensity, frequency and duration of pain perception (11). Emotion regulation is a set of processes that control and evaluate a person's emotional reactions and even change these reactions if necessary, so that the person functions properly (12). The results of studies show that there is a relationship between the locus of control and regulation of emotion. Patients with an internal control source, experience less pain intensity than patients with an external control source. Patients with impaired emotion regulation also experience greater pain intensity (5). On the other hand, most studies have examined the relationship between these components in a correlational manner, but the mediating role of emotion regulation in the relationship between loci of control, pain intensity and the interactive relationship of variables have not been investigated. According to the above points, the present study aimed to investigate the mediating role of emotion regulation in the relationship between locus of control and pain intensity in chronic pain patients Methods: The method of this research is descriptive and correlational. The statistical population of this study was all patients with chronic pain of Esfarayen in 2019. The sample consisted of 200 patients with chronic pain aged 25 to 45 years who were selected by available sampling method from Imam Khomeini Hospital, specialized clinic of medical sciences and health centers of Shahid Shokouhi, Shahid Montazeri and Imam Reza (AS). Brief pain inventory, health locus of control scale and emotion regulation questionnaire were used as research tools. Correlation test, regression analysis and path analysis were used to analyze the findings. Data were analyzed using SPSS-23 software. Results: Based on the findings, the mediating role of emotion regulation (re-evaluation- suppression) in the relationship between the source of internal control and pain intensity was confirmed. In this way, individuals with a source of internal control were more likely to use an adaptive reassessment strategy and less of a maladaptive repression strategy, and consequently experienced less pain intensity. Furthermore; In this study, the mediating role of emotion regulation (re-evaluation-suppression) in the relationship between external control source and pain intensity was also confirmed. According to this finding, people with an external source of control were more likely to use a maladaptive suppression strategy that leads to more severe pain. Conclusion: The results of this study supported the mediating role of emotion regulation in the relationship between locus of control and pain intensity. This finding indicates the importance of emotion regulation in explaining the severity of pain in patients with chronic pain. The findings of this study showed that emotion regulation (re-evaluation - suppression) has a mediating role in the relationship between external control source and pain intensity in patients with chronic pain. Incompatible emotion management strategies, such as repression or catastrophe, lead to reduced physical and social activity, psychological disorders, and feelings of helplessness and lack of control. So that the feeling of lack of control, in turn, intensifies the experience of pain. Thus, people come to believe that they have no sense of control and form a vicious circle (5). One of the most fundamental reasons people turn to dysfunctional emotional regulation strategies such as avoiding, repressing, criticizing, blaming themselves or others, and paving the way for the formation of chronic psychological disorders, including chronic pain, is the belief in lack of internal control (30). Some of the beliefs of most patients with chronic pain are that "my illness is the fault of my spouse, child or boss", "my pain is terrible", "I am going crazy" (31). As a result, patients engage in a maladaptive emotional behaviors and strategies, such as criticizing, blaming themselves or others, or even suppressing their emotions, in order to gain a sense of control over their illness and pain (30). Patients with chronic pain lose more control over the disease and their condition, which leads to more pain. Emotion regulation (re-evaluation - suppression) mediates the relationship between the source of internal control and pain intensity in people with chronic pain. Patients who use adaptive emotion management strategies in the face of problems, ie; problem-oriented strategy, define stressors, and therefore, such people experience fewer negative outcomes and feel more in control of their condition and experience less pain intensity. These patients are more successful in solving problems and dealing effectively with stress caused by life events, and this effective coping and satisfaction in solving the problems makes them feel in control of the stress which caused by important life events. The source of internal control is related to accepting pain and being prepared for change. In general, self-regulation is one of the factors that can be effective in causing or controlling pain in patients. People with chronic pain will be able to prevent information bias in the processing of information that leads to the experience of negative emotions by adjusting their emotions through the relationship between pains and adapt more effectively to their illness (33). Therefore, if the training program of these patients is accompanied by emotion regulation strategies, it can help reduce the severity of pain in these patients. </div> شدت درد, منبع کنترل, راهبردهای تنظیم هیجان Pain intensity, Locus of control, Emotion regulation strategies 1 12 http://rjms.iums.ac.ir/browse.php?a_code=A-10-6397-1&slc_lang=fa&sid=1 Reza Ariavand رضا آریاوند rariyavand00@gmail.com 3900319475328460088833 3900319475328460088833 Yes Master of Clinical Psychology, Kharazmi University, Tehran, Iran کارشناس ارشد روانشناسی بالینی، دانشگاه خوارزمی، تهران، ایران Robabeh Nouri ربابه نوری 3900319475328460088834 3900319475328460088834 No Associate Professor, Department of Clinical Psychology, Kharazmi University, Tehran, Iran دانشیار، گروه روانشناسی بالینی، دانشگاه خوارزمی، تهران، ایران Jafar Hassani جعفر حسنی 3900319475328460088835 3900319475328460088835 No Associate Professor, Department of Clinical Psychology, Kharazmi University, Tehran, Iran دانشیار، گروه روانشناسی بالینی، دانشگاه خوارزمی، تهران، ایران Atefeh Zandifar عاطفه زندی فر 3900319475328460088836 3900319475328460088836 No Assistant Professor Alborz University of Medical Sciences, Iran استادیار، دانشگاه علوم‌ پزشکی البرز، کرج، ایران