慢性疼痛病人人格特質、治療滿意度和順從性

Personality Characteristics, Treatment Satisfaction, and the Adherence of Patients with Chronic Pain

目的：人格會影響人們對問題的看法以及問題解決的風格，進而影響他們的求醫行為和結果。本研究的目的是探討慢性疼痛病患雙親依附、人格特質和求醫行為間的關係。方法：共有86 位（82.6% 男性，平均年齡30.02 歲）由慢性疼痛門診，排除有精神診斷的病人完成所有的問卷。問卷包含治療滿意度問卷、雙親教養態度量表 (Parental Bonding Inventory) 及艾氏人格問卷 (Eysenck Personality Inventory)。結果：感覺母親顯著的比較關懷的病人比較外向(β = 0.27, p < 0.001)。顯著的比較外向的人比較有可能覺得治療有幫助 (β = 0.33, p < 0.001)，並且對治療感到滿意 (β = 0.36, p < 0.001)，而會顯著的影響他們再次接受治療的意願 (β =0.33, p < 0.001)。覺得治療有幫助是為母親關懷、神經質及願意再接受治療顯著的中介因素 (β= 0.39, p < 0.001)。年紀是重要的影響因素，年紀比較大的人顯著的比較可能覺得治療有幫助(β = 0.26, p < 0.001)，並且顯著的感到滿意 (β = 0.38, p < 0.001)，進而增加他們再次接受治療的意願。性別對求醫行為並沒有顯著的影響。結論：母親依附和人格特質是病人順從性的遠因；病人滿意度或再次願意接受治療的意願是近因。醫師或政策制定者可以使用本研究結果來促進慢性疼痛病患的治療效用及效率。進一步的研究必須瞭解不同族群的順從風格，以建立完整且具理論基礎的治療。

Objective: Personality may influence people's outlook on problems and problem solving styles, which affects their health seeking behavior and outcomes. The objective of this study was to investigate the relationship among parental attachment, personality characteristics, and help-seeking behavior in chronic pain patients. Methods: We recruited 86 participants (82.6% males, mean age 30.02 years) from the chronic pain clinic without a psychiatric diagnosis. They completed all copies of questionnaire including treatment satisfaction survey, Parental Bonding Inventory, and Eysenck Personality Inventory. Results: Patients who perceived their mothers as significantly more caring were more extraverted (β = 0.27, p ＜ 0.001). Moreover, those that were significantly more extraverted to find their treatment helpful (β = 0.33, p ＜ 0.001) and to be satisfied with the treatment (β = 0.36, p ＜ 0.001), which significantly influenced their willingness to come again for treatment (β = 0.33, p ＜ 0.001). Finding the treatment helpful was found to be a significantly mediating factor between maternal caring, neuroticism, and willingness to accept the treatment (β = 0.39, p ＜ 0.001). In addition, age was also an important contributing factor. Older people found the treatment as significantly more helpful (β = 0.26, p ＜ 0.001) and satisfying (β = 0.38, p ＜ 0.001), which increased their willingness to come again for treatment. Gender did not show to have any significant influence on help-seeking behavior. Conclusion: Maternal attachment and personality characteristics were distant factors in patients' adherence, and patients being satisfied or willingness to accept the treatment again are proximal factors. This result could be used as a reference for physicians or policy makers to facilitate effectiveness and efficiencies for treatment of patients with chronic pain. Further research are needed to develop comprehensive and theoretically based treatment after understanding adherence style in different kinds of groups.