| Sažetak | Cilj ovog istraživanja je bio proširiti naše znanje o povezanosti različitih
okolišnih, psiholoških i nasljednih čimbenika s percepcijom akutne, eksperimentalno
uzrokovane mehaničke boli.
U ovu presječnu studiju uključeno je 2 500 odraslih osoba oba spola starijih od
18 godina s otoka Visa, Korčule i grada Splita. Korištenjem algometra izazivali smo
pritisak na kažiprst desne i lijeve ruke ispitanika, koji se pri određenom pritisku pretvara
u bolni podražaj. Pritom smo mjerili prag osjeta na bol i toleranciju boli, a iz razlike
tolerancije i praga osjeta boli smo izračunali interval boli, kao mjeru koja ukazuje na
sposobnost ispitanika za toleriranje boli koju osjeća. U svrhu prikupljanja podataka o
sociodemografskim, psihološkim, zdravstvenim te ponašajnim odrednicama korišten je
opširan upitnik.
U analizi podataka smo izračunali heritabilnost praga, tolerancije i intervala boli
za ispitanike s otoka Visa i Korčule. Povezanost između različitih okolišnih i
psiholoških odrednica i doživljavanja boli analizirana je pomoću metoda bivarijatne
statistike, kao i korištenjem multivarijatne linearne regresijske analize. Varijable koje
smo uključili u regresijsku analizu kao odrednice eksperimentalne akutne boli bile su
dob, spol, mjesto stanovanja, broj godina školovanja, imovinski status, omjer struka i
bokova, prisutnost kroničnih bolesti, pušenje, konzumacija alkohola, tjelesna aktivnost,
mentalni distres, psihoticizam, ekstrovertiranost, neuroticizam, sklonost laganju i
optimizam.
Heritabilnost praga osjeta boli u ispitanika oba spola s otoka Visa iznosila je
50,8% na desnoj i 36,2% na lijevoj ruci, dok je heritabilnost tolerancije na bol iznosila
54,2% na desnoj ruci, a na lijevoj ruci nije bila statistički značajna. Heritabilnost praga
osjeta boli u ispitanika s otoka Korčule je iznosila 53% na desnoj i 49,8% na lijevoj
ruci, heritabilnost tolerancije na bol je bila 50,3% na desnoj i 53,8% na lijevoj ruci, dok
je heritabilnost intervala boli bila 45,4% na desnoj i 47,3% na lijevoj ruci.
Dispozicijski optimizam je bio značajno pozitivno povezan s tolerancijom boli
izazvanom mehaničkim pritiskom na desnoj ruci (β=0,46; p=0,030), kao i na lijevoj
ruci (β=0,55; p=0,015). Također, i interval boli je bio pozitivno povezan s
dispozicijskim optimizmom i na desnoj ruci (β=0,42; p=0,030) i na lijevoj ruci (β=0,46;
p=0,029). S druge strane, nije bilo statistički značajne povezanosti između praga osjeta
boli i dispozicijskog optimizma. Ovo ukazuje na to su optimističniji ispitanici mogli
uspješnije tolerirati bol, unatoč tome što su jednako osjetljivi na bol kao i ispitanici koji
su manje optimistični.
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S obzirom da smo mjerenja osjeta boli proveli na obje ruke, istražili smo kako
na percepciju boli utječe dominantnost ruke ispitanika. Rezultati ukazuju da ne postoje
razlike u percepciji boli između dešnjaka, ljevaka i ambidekstera. Međutim, unutar
svake od ove tri podskupine postoje određene razlike, pa su tako dešnjaci imali viši prag
osjeta boli, toleranciju na bol, kao i interval boli na dominantnoj (desnoj) ruci, dok ovi
nalazi nisu potvrđeni kod ljevaka.
Ovo istraživanje pokazuje da na percepciju boli utječe velik broj različitih
čimbenika, koji zajedno kreiraju individualni doživljaj boli. Među tim čimbenicima
ističe se optimizam kao čimbenik temeljem kojeg bi se u budućnosti mogle kreirati
psihološke intervencije s ciljem povećanja razine optimizma i time omogućavanja
lakšeg nošenja s bolnim podražajima i uspješnijom tolerancijom boli. |
| Sažetak (engleski) | The aim of this study was to expand our knowledge on the association between various
environmental, psychological and heritable factors and the perception of acute experimentally
induced mechanical pain.
This cross-sectional study included 2,500 adults of both sexes older than 18 years, living
on the island of Vis, Korčula and the city of Split. Using an algometer, we caused pressure on
the index finger of the right and left hand of the subject, which at a certain pressure turned into
a painful stimulus. We measured the pain threshold and pain tolerance, and from the difference
between the tolerance and pain threshold, we calculated the pain interval as a measure that
indicates the subject's ability to tolerate the pain. In order to collect data on socio-demographic,
psychological, health and behavioral determinants, an extensive questionnaire was used.
In the data analysis, we calculated the heritability of the pain threshold, tolerance and
pain interval for subjects from the islands of Vis and Korčula. The association between various
environmental and psychological determinants and pain perception was analyzed using
bivariate statistical methods, as well as multivariate linear regression analysis. The variables
included in the regression analysis as determinants of experimental acute pain were age, sex,
place of residence, number of years of education, material status, waist-to-hip ratio, presence
of chronic diseases, smoking, alcohol consumption, physical activity, mental distress,
psychoticism, extroversion, neuroticism, tendency to lie and optimism.
The heritability of pain threshold in subjects from the island of Vis was 50.8% on the
right and 36.2% on the left hand, while the heritability of pain tolerance was 54.2% on the right
hand, but it was not statistically significant on the left hand. The heritability of pain threshold
in subjects from the island of Korčula was 53.0% on the right and 49.8% on the left hand, the
heritability of pain tolerance was 50.3% on the right and 53.8% on the left hand, while the
heritability of pain interval was 45.4% on the right hand and 47.3% on the left hand.
Dispositional optimism was significantly and positively associated with pain tolerance
induced by mechanical pressure on the right hand (β=0.46; p=0.030) and on the left hand
(β=0.55; p=0.015). Also, pain interval was positively associated to dispositional optimism on
both the right hand (β=0.42; p=0.030), and the left hand (β=0.46; p=0.029). On the other hand,
there was no statistically significant association between pain threshold and dispositional
optimism. This suggests that more optimistic subjects were able to tolerate pain more
successfully, despite being just as sensitive to pain as less optimistic subjects.
Given that we measured pain perception on both hands, we had the opportunity to
investigate how the perception of pain is affected by the dominance of the subject's hand. The
results indicate that there were no differences in the perception of pain between right-handed,
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left-handed and ambidextrous people, but there were certain differences within each of the
groups. For instance, right-handed people had a higher pain threshold, pain tolerance, and pain
interval on the dominant (right) hand, while these findings have not been confirmed in lefthanded people.
This study shows that the perception of pain is influenced by a large number of different
factors and characteristics that together create the individual experience of pain. Among these
factors, optimism stands out as a factor that could be used for creating psychological
interventions in the future, with the aim of increasing optimism and thus enabling easier coping
with painful stimuli and more successful pain tolerance. |
