The Life Quality And Executive Function Of Chronic Low Back Pain Patients And Its Affecting Factors

Object: The life quality of chronic low back pain patients and its affecting factors: Examine the mood, sleep, pain self-efficacy and alexithymia in chronic pain group, and analyze the predictive effect of clinic symptom, alexithymia, pain self-efficacy on the life quality in chronic low back pain patients, and investigate the relationship between clinic symptom , alexithymia, pain self-efficacy in chronic low back pain patients. (2) The executive function of chronic low back pain patients and its affecting factors: Examine the mood, sleep, pain self-efficacy and executive function of chronic pain patient, and analyze the relationship between clinic sypmtoms, pain self-efficacy, and executive function, and the relationship between the components(selective attention, sustain attention, inhibition function, set shifting) of executive function.Method: (1) 190 chronic pain patient and 120 health control completed Demographics questionnaire,Toronto alexithymia scale(TAS), Short Form McGill Pain Questionnaire(sf-MPQ), Athens insomnia scale (AIS) , Pain Self-efficacy scale(PSEQ), Beck depression Inventory (BDI),Beck Anxiety Inventory(BAI), The 12-item Short Form Health Survey(sf-12), the psychological evaluation results by t test compared the results between chronic pain group and control group. Use multiple regression analysis to investigate the relationship between alexythmia, depression, anxiety, insomnia, affective pain, sensory pain, the intensity of pain(VAS) , self-efficacy and life-quality.(2)85 chronic low back pain patients and 102 normal control finish the Arrow test, Stroop test, Continue performance test, Wisconsin Card Sorting Test (WCST) and Sf-MPQ,BDI, BAI, AIS, PSEQ, using t test compare the psychological test result and executive function of chronic pain group with normal control, using multiple regression analysis exam the predictive effects of depression, anxiety, affective pain, sensory pain, pain intensity and pain self-efficacy on the components of executive function, and analyzed the relationship between the test results.Results: (1) The life quality of chronic patients and its affecting factors : the score of TAS,BDI,BAI,AIS in chronic pain patient are higher than control group (p<0.01) ,while the score of SF-12 is lower than control group (p<0.01) ,the score of TAS, affective pain, VAS, BDI, AIS, PSEQ were found to predict the life quality of chronic pain patient (p < 0.01); the score of TAS , BAI,AIS were found to predict the affective pain (p<0.05) , the score of PSEQ was found to predict the sensory pain (p<0.05) , the score of BDI was found to predict the score of VAS (p<0.05) ; the score of TAS, affective pain, VAS, PSEQ, AIS, BAI were found to predict the score of BDI(p<0.05); the score of TAS, number of pain episodes per week, affective pain, BDI, BAI were found to predict the score of AIS (p<0.05) , the score of BDI were found to predict the score of PSEQ (p<0.05) . (2) The executive function of chronic patients and its affecting factors : The total reaction time of arrow test-1 and arrow test-2 of chronic pain group in "Response compatible" were longer than control group, the interference score of arrow test-2 and stroop test of chronic pain group were higher than control group,CPT-3 correct press times was less than control group (p<0.05) ,the continuous error times of chronic pain group in WCST is more than control group (p<0.05) ,after control the effect of age, education, PSEQ was found to predict total reaction time in "Response Compatible" arrow test-2(p<0.05 ),AIS and affective pain were found to predict the interference score of arrow test-2 (p< 0.05 ) ,PSEQ and AIS were found to predict CPT-3 correct press times, AIS and sensory pain were found to predict the continuous error of WCST (p<0.05) ,the correlation analysis indicate the interference score of arrow test-2 were correlated with CPT-3 correct press times ,continuous errors of WCST in both normal control group and chronic pain group (p<0.05) ; the interference score of stroop is not correlated with CPT-3 correct press times and continuous error in WCST (P > 0.05 ), CPT-3 correct press times correlated with continuous error times in WCST significantly (p<0.05) .Conclusions: (1) Chronic pain group with alexithymia, anxiety , depression, insomnia. alexithymia, clinical symptoms and pain self-efficacy are highly correlated; (2)Executive function including selective attention, sustained attention, inhibition function and set shifting in chronic low back pain patient were impaired, affective pain, sensory pain, insomnia, and pain self-efficacy were found to predict the components of executive function of patient alone or simultaneously.