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마음챙김이 통증에 미치는 영향: 매개변인으로 통증파국화와 신체자각을 중심으로

Mindfulness and pain : focusing on body awareness and pain catastrophizing as process variables

김완석|심교린
사단법인 한국명상학회 (Korean Society for Meditation)|2021.08|한국명상학회지 (Korean Journal of Meditation)|제11권 제2호|pp. 21-37|DOI 10.23250/kjm.11.2.202108.002

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pain마음챙김Mindfulnessinteroceptive awarenessK-MBSR통증신체자각통증파국화

초록

인간은 끊임없이 통증을 관리하고 조절하고자 노력해왔다. 특히 최근에는 외과적 처치와 약물의 사용과 같은 의학적 방법 뿐 아니라, 심신 통합적 관점에서 통증을 이해하고 조절하려는 시도가 주목받고 있다. 특히, 마음챙김에 기반한 중재들은 통증 뿐 아니라 삶의 전반에 걸쳐 긍정적인 효과를 나타낸다는 연구 결과들이 축적되어 왔다. 본 연구는 마음챙김이 통증에 미치는 영향과 여기에 매개변인으로 통증파국화와 신체자각의 기능을 살펴보고자 한다. 이를 위해 예비연구에서는 만성적인 통증을 보고하는 노인 50명을 대상으로 마음챙김에 기반한 표준화 프로그램인 K-MBSR이 신체자각에 미치는 영향을 알아보고, 본 연구를 통해 문헌 고찰에 따른 마음챙김과 통증, 통증파국화, 신체자각의 관계에 대한 가정을 설정하고, 364명의 일반인과 대학생을 대상으로 자기보고식 질문지를 통해 마음챙김, 경험하는 통증 강도, 통증파국화, 신체자각, 통증수용에 대한 자료를 수집하여 구조방정식 모형검증을 통해 확인하였다. 연구 결과, 마음챙김은 통증파국화를 매개로 하여 통증강도를 감소시키고, 신체자각의 감각수용과 감각복귀를 통해 통증에도 불구하고 일상생활을 잘 영위하는 활동 참여를 증진시키는 것으로 나타났다. 또한 마음챙김을 통한 자각의 증가로 통증 강도에 대한 자각이 증가하지만, 감각수용을 증진시키고 통증파국화를 감소시켜 전체적으로는 통증강도를 감소시키는 매커니즘을 양적 자료를 통해 제시하였다는 의의가 있다.

Abstract

Humans have consistently endeavored to manage and control pain; recently, attempts to understand and control pain from a mind-body integration perspective have become more common, rather than solely from medical methods such as surgical treatment and drug use. In particular, recent research shows that mindfulness-based interventions have positive effects not only on pain but throughout various facets of individuals’ lives. The purpose of this study is to investigate the effect of mindfulness on pain and how interoceptive awareness and pain catastrophizing function between mindfulness and pain. In a preliminary study, we investigated the effect of Korean Mindfulness-Based Stress Reduction (K-MBSR)—a standardized program based on mindfulness—on interoceptive awareness in 50 elderly people reporting chronic pain. We then developed assumptions about the relationships among mindfulness, pain action, pain catastrophizing, and interoceptive awareness and collected data via questionnaires sent to 364 general and university students. The methods of this study were confirmed by structural equation model verification. Results show that mindfulness decreased the intensity of pain by mediating pain catastrophizing. It also increased “accept and return to body” in interoceptive awareness and improved participation in daily life activities despite pain. This paper provides meaningful quantitative evidence suggesting that an increase in awareness through mindfulness increases the awareness of the intensity of pain, but interoceptive awareness decreases pain catastrophizing and intensity of pain.

참고문헌 (45)

  1. 김완석, "한국판 다차원 신체자각척도(K-MAIA): 개발과 타당화", 스트레스 硏究, 24(3), pp.177~192 (2016), 대한스트레스학회[DOI]
  2. 김정진, "조직변화에 대한 구성원 저항의 다차원적 접근", 인사조직연구, 16(3), pp.1~41 (2008), 한국인사조직학회
  3. 박성현, "마음챙김 척도 개발", 박사, pp.2006
  4. 신재숙, "만성통증 환자의 수용과 마음챙김이 재앙적 사고와 우울 및 통증에 미치는 영향: 수용과 마음챙김의 조절효과", 스트레스 硏究, 22(1), pp.11~21 (2014), 대한스트레스학회
  5. 안상섭, "한국형 마음 챙김 명상에 기반한 스트레스 감소 프로그램이 만성통증에 미치는 효과 : 근로자를 중심으로", 박사, 심리학, pp.2007
  6. Anderson, J. C., "Structural equation modeling in practice : A review and recommended two-step approach", Psychological Bulletin, 103(3), pp.411~423 (1988)
  7. Astin, J. A., "The efficacy of mindfulness meditation plus Qigong movement therapy in the treatment of fibromyalgia : A randomized controlled trial", Journal of Rheumatology, 30(10), pp.2257~2262 (2003)
  8. Baas, L. S., "An exploratory study of body awareness in persons with heart failure treated medically or with transplantation", Journal of Cardiovascular Nursing, 19(1), pp.32~40 (2004)
  9. Bornemann, B., "Differential changes in self-reported aspects of interoceptive awareness through 3 months of contemplative training", Frontiers in Psychology, 6, pp.1~13 (2015)[DOI]
  10. Burns, J. W., "The role of attentional strategies in moderating links between acute pain induction and subsequent psychological stress : Evidence for symptom-specific reactivity among patients with chronic pain versus healthy nonpatients", Emotion, 6(2), pp.180~192 (2006)
  11. Chiesa, A., "Mindfulness-based interventions for chronic pain : A systematic review of the evidence", Journal of Alternative & Complementary Medicine, 17(1), pp.83~93 (2011)
  12. Cho, S., "Psychometric properties of a Korean version of the Chronic Pain Acceptance Questionnaire in chronic pain patients", Quality of Life Research, 21(6), pp.1059~1064 (2012)
  13. Cho, S., "Validation of the Korean version of the pain catastrophizing scale in patients with chronic non-cancer pain", Quality of Life Research, 22(7), pp.1797~1772 (2013)
  14. Flor, H., "Effect of sensory discrimination training on cortical reorganization and phantom limb pain", The Lancet, 357(9270), pp.1763~1764 (2001)
  15. Fornell, C., "Evaluating structural equation models with unobservable variables and measurement error", Journal of Marketing Research, 18(1), pp.39~50 (1981)
  16. Fornell, C., "Validity assessment : A structural equations approach using partial least squares" (1982), American Marketing Association
  17. Gardner-Nix, J., "Evaluating distance education of a mindfulness-based meditation programme for chronic pain management", Journal of Telemedicine & Telecare, 14(2), pp.88~92 (2008)
  18. Germer, C. K., "마음챙김과 심리치료" (2012), 학지사
  19. Ginzburg, K., "Body awareness and pain habituation : the role of orientation towards somatic signals", Journal of Behavioral Medicine, 38(6), pp.876~885 (2015)
  20. Goldenberg, D. L., "A controlled study of a stress-reduction, cognitive-behavioral treatment program in fibromyalgia", Journal of Musculoskeletal Pain, 2(2), pp.53~66 (1994)
  21. Goubert, L., "Distraction from chronic pain during a pain-inducing activity is associated with greater post-activity pain", Pain, 110(1), pp.220~227 (2004)
  22. Grossman, P., "Mindfulness training as an intervention for fibromyalgia : Evidence of post intervention and 3-year follow-up benefits in well-being", Psychotherapy and Psychosomatics, 76(4), pp.226~233 (2007)
  23. Hanley, A. W., "Holding the body in mind : Interoceptive awareness, dispositional mindfulness and psychologycal well-being", Journal of Psychosomatic Research, 99, pp.13~20 (2017)
  24. Hong, S., "Testing configural, metric, scalar, and latent mean invariance across genders in sociotropy and autonomy using non-western sample", Educational and Psychology Measurement, 63(4), pp.636~654 (2003)
  25. Kabat-Zinn, J., "The clinical use of mindfulness meditation for the self-regulation of chronic pain", Journal of Behavioral Medicine, 8(2), pp.163~190 (1985)
  26. Kabat-Zinn, J., "Four-year follow-up of a meditation-based program for the self-regulation of chronic pain : Treatment outcomes and compliance", Clinical Journal of Pain, 2(3), pp.159~173 (1986)
  27. Kabat-Zinn, J., "Full catastrophe living : Using the wisdom of your body and mind to face stress, pain, and illness" (1990), Dell
  28. Kingston, J., "A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity", Journal of Psychosomatic Research, 62(3), pp.297~300 (2007)
  29. Mailloux, J., "Somatosensory amplification and its relationship to heartbeat detection ability", Psychosomatic Medicine, 64(2), pp.353~357 (2002)
  30. McCracken, L. M., "Behavioral constituents of chronic pain acceptance : Results from factor analysis of the Chronic Pain Acceptance Questionnaire", Journal of Back and Musculoskeletal Rehabilitation, 13(2), pp.93~100 (1999)
  31. McCracken, L. M., "The role of mindfulness in a contextual cognitive-behavioral analysis of chronic pain-related suffering and disability", Pain, 131(1), pp.63~69 (2007)
  32. McIntosh, W. D., "East meets West : Parallels between Zen Buddhism and social psychology", International Journal for the psychology of relegion, 7, pp.37~52 (1997)
  33. Mehling, W. E., "Body awareness : Construct and self-report measures", PLos ONE, 4(5), pp.1~18 (2009)[DOI]
  34. Mehling, W. E., "The multidimensional assessment of interoceptive awareness", PLos ONE, 7(11), pp.1~22 (2012)[DOI]
  35. Morone, N. E., "Mindfulness meditation for the treatment of chronic low back pain in older adults : A randomized controlled pilot study", Pain, 134(3), pp.310~319 (2008)
  36. Morone, N. E., "A mind-body program for older adults with chronic low back pain : Results of a pilot study", Pain Medicine, 10(8), pp.1395~1407 (2009)
  37. Plews-Ogan, M., "A pilot study evaluating mindfulness based stress reduction and massage for the management of chronic pain", Journal of General Internal Medicine, 20(12), pp.1136~1138 (2005)
  38. Pradhan, E. K., "Effect of mindfulness-based stress reduction in rheumatoid arthritis patients", Arthritis Care and Research, 57(7), pp.1134~1142 (2007)
  39. Randolph, P. D., "The long-term combined effects of medical treatment and a mindfulness-based behavioral program for the multidisciplinary management of chronic pain in west Texas", Pain Digest, 9(2), pp.103~112 (1999)
  40. Reiner, K., "Do Mindfulness-Based Interventions Reduce Pain Intensity? A Critical Review of the Literature", Pain Medicine, 14(2), pp.230~242 (2013)
  41. Sagula, D., "The effectiveness of mindfulness training on the grieving process and emotional well-being of chronic pain patients", Journal of Clinical Psychology in Medical Settings, 11(4), pp.333~342 (2004)
  42. Sephton, S. E., "Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia : Results of a randomized clinical trial", Arthritis Care and Research, 57(1), pp.77~85 (2007)
  43. Sullivan, M. J. L., "The pain catastrophizing scale : Development and validation", Psychological Assessment, 7(4), pp.524~532 (1995)
  44. Zautra, A. J., "Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression", Journal of Consulting and Clinical Psychology, 76(3), pp.408~421 (2008)
  45. Zeidan, F., "Brain mechanisms supporting the modulation of pain by mindfulness meditation", The Journal of Neuroscience, 31(14), pp.5540~5548 (2011)

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