痛みと緩和のジャーナル

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Prevalence Of Stigmatization And Poor Self-Esteem In Chronic Pain Patients

Hegarty D* and Wall M

Objective: Stigma and poor self-esteem (defined as the internalized cognitive, emotional, and behavioural impact of others’ negative attitudes on a person) are associated with many chronic health conditions and have indirect but strongly negative implications for clinical prognosis. We sought to estimate the prevalence of perceived stigmatization and self-esteem in chronic pain patients and its relationship with general health markers.

Methods: All adult patients (n=160, >18 years old, chronic pain >3 months) completed a set of validated questionnaires; Stigmata Scale for Chronic Illness (SSCI), Rosenberg’s Self-esteem Scale (RSES); Hospital Anxiety Depression Scale (HADS); Brief Pain Inventory short form (BPI); and the General health survey (SF12v2). Data was recorded using Microsoft Excel and analyzed using SPSS.

Results: The mean pain intensity score (Visual analogue score (VAS)) was 6.1 ± 1.7. 77% of patients (123/160) had a lowered self-esteem (RSES score=17.2 ± 14.5) with a mean SSCI score of 50.8 ± 19.0 (normal range 24-120). An inverse relationship between (a) stigmatization and self-esteem (Pearson correlation, r=.58, p<0.001) and (b) selfesteem and pain interference (r=.48, p<0.001) was identified. A positive correlation between stigmatization and anxiety (r=.228, p<.05) and an inverse relationship between self-esteem and depression existed (r=.234, p<.05).

Conclusions: A high prevalence of stigmatization was identified in individuals experiencing chronic pain and a significant correlation exists between the type of stigma experienced, the level of pain intensity and other psychological factors including self-esteem, anxiety, and depression