Coping Patterns in Chronic Low Back Pain : Relationship with Locus of Control and Self-Efficacy

만성 요통 환자의 대처 유형과 건강 통제위, 자기효능감과의 관계

Coping patterns were investigated in a sample of 126 patients with chronic low back pain by means of self-reported questionnaire. Based on the previous researches, coping pat terns were divided into the active cognitive coping, the active behavioral coping, the passive cognitive coping, and the passive behavioral coping. While all the above coping patterns were used, the passive behavioral coping was found to be used most frequently. Six subgroups were identified by cluster analytic procedure using their scores of the coping scale : active cognitive coper, general active coper, passive behavioral coper, general passive coper, multidimensional coper, and multi dimensional non-coper. Six subgroups were compared regarding locus of control, self-efficacy, pain and demographic variables. Distinct differences appeared among subgroups in internal locus of control, self-efficacy, and pain. General active coper and active cognitive coper had higher internal locus of control, higher self-efficacy, and lower pain. General passive coper and multidimensional non-coper had lower internal locus of control, lower self-efficacy, and higher pain. Passive behavioral coper had higher internal locus of control, lower self-efficacy, and higher pain. It supports the concept of learned helplessness due to prior experiences. Multi dimensional coper had higher internal, higher powerful others, and higher self-efficacy. So it corresponds to 'believer in control' group Identified by Wallston et at(1982). Unexpectedly this group also complained more pain. It could be interpreted in two ways. The more coping methods they use, the more they complain pain ; which is the result of Folkman et al (1986). Or they might be typical 'yea sayers'. These unique groups-passive behavioral coper and multidimensional coper-identified by this study supports the suggestion of Wallston et al(1982), about locus of control : individual's pattern of responses across the three scales may be more predictive than his or her scores on each of the scale seperately. The fact that passive coping was used more than active coping also suggests that self controlled active co ping is encouraged to chronic patients as well as acute patients. And it is necessary to articulate the coping scale and self-efficacy scale. It is also necessary to study the relationship of coping and adjustment by experimental design.