The association between neighbourhood socio-economic status and the onset of chronic widespread pain: Results from the EPIFUND study
The association between neighbourhood socio-economic status and the onset of chronic widespread pain: Results from the EPIFUND study
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DOI：
10.1016/j.ejpain.2008.07.003
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发表时间：
2009-07-01
影响因子：
3.6
通讯作者：
McBeth, John
中科院分区：
文献类型：
--
作者：
Davies, Kelly A.;Silman, Alan J.;McBeth, John
背景：横断面研究已经报道了社会经济地位与慢性广泛性疼痛(CWP)患病率之间的负相关关系。然而，这种关系在多大程度上是由心理因素来解释的还不得而知。这项研究的目的是检验社会经济地位预测煤工尘肺发病的假设，但这种关系将由心理因素来解释。方法：来自三个不同社会经济领域的受试者被招募到基于人群的前瞻性疼痛调查中。受试者在基线上完成一份调查问卷，评估疼痛状况、心理因素和职业。15个月后，受试者完成了评估疼痛状态的随访问卷。结果：共有3489名受试者在基线时没有煤工尘埃，符合随访条件，其中2782人(79.7%)参与调查。其中，281名(10%)受试者被归类为新的煤工尘肺。Logistic回归分析显示，中等和最不富裕地区的煤工尘肺患病率分别是最富裕地区的1.47倍(95%CI：1.08~2.01)和1.35倍(95%CI：1.00~1.82)。但在控制心理因素的逐步多元Logistic回归分析中，新发煤工尘肺与社会经济状况的关系不再明显。结论：社会经济状况与新发煤工尘肺有关，但这种关系是由心理因素解释的。了解社会经济地位和疼痛之间联系的潜在因素应有助于设计干预策略，以减轻已确定的高危人群中慢性疼痛的负担。(C)2008年欧洲国际疼痛研究协会分会联合会。爱思唯尔有限公司出版。保留所有权利。
Background: Cross-sectional studies have reported an inverse relationship between socio-economic status and the prevalence of chronic widespread pain (CWP). However, the extent to which this relationship is explained by psychological factors is unknown. The aim of this study was to examine the hypothesis that socio-economic status predicts the onset of CWP but that this relationship would be explained by psychological factors.Methods: Subjects from three diverse socio-economic areas were recruited into a population-based prospective survey of pain. Subjects completed a questionnaire at baseline that assessed pain status and psychological factors and occupation. Fifteen months later subjects completed a follow-up questionnaire which assessed pain status.Results: A total of 3489 subjects were free of CWP at baseline and eligible for follow-up, of whom 2782 (79.7%) participated. Of those, 281 (10%) subjects were classified as having new CWP. Logistic regression analysis revealed that compared to subjects from the most affluent socio-economic area, those from the moderate and least affluent areas were respectively, 1.47 (95% CI: 1.08-2.01) and 1.35 (95% CI: 1.00-1.82) times more likely to have new CWP. However, in a stepwise multivariate logistic regression analysis, controlling for psychological factors, the relationship between new onset CWP and socio-economic status was no longer evident.Conclusions: This study has demonstrated that socio-economic status is related to new onset CWP, but the association is explained by psychological factors. Understanding the factors underlying the association between socio-economic status and pain should help to design intervention strategies which may reduce the burden of chronic pain in identified high risk Population groups. (C) 2008 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.