The relationship of sociodemographic and psychological variables with chronic pain variables in a low-income population
The relationship of sociodemographic and psychological variables with chronic pain variables in a low-income population
复制标题
DOI：
10.1097/j.pain.0000000000000964
复制
发表时间：
2017-09-01
期刊：
影响因子：
7.4
通讯作者：
Thorn, Beverly E.
中科院分区：
文献类型：
--
作者：
Newman, Andrea K.;Van Dyke, Benjamin P.;Thorn, Beverly E.
慢性疼痛是一种普遍存在的疾病，由于经济，教育和种族差异而变得复杂。这项研究分析了在研究不足和服务不足的人群中与慢性疼痛相关的关键因素。样本的特点是三重差距方面的收入，教育/识字，种族障碍，大大增加了脆弱性的负面后果的慢性疼痛。该研究检查了290名参加学习我的疼痛试验的参与者的治疗前数据，这是一项心理社会干预的随机对照比较有效性试验（B.E.T.，主要研究者，以患者为中心的结局研究所合同号941; clinicaltrials.gov标识符NCT 01967342）。分层多元回归分析评价了社会人口学（性别、年龄、种族、贫困状况、文化程度和教育水平）和心理（抑郁症状和疼痛灾难化）变量与疼痛干扰、疼痛严重程度和残疾之间的关系。抑郁症状和疼痛灾难化对社会人口统计学和疼痛变量的间接影响进行了研究，使用自举回归。还审查了反向调解模式。结果表明，在这个低收入样本的慢性疼痛的经验是更好地占心理因素比性别，年龄，种族，贫困状况，识字和教育水平。抑郁症状和疼痛灾难化介导的年龄和疼痛变量之间的关系，而疼痛灾难化介导的小学识字率和贫困状况的影响。一些反向模型与假设模型相当，提示了双向性的可能性。虽然横断面研究结果不能建立因果关系，但我们的研究结果强调了心理因素在慢性疼痛和多种健康差异个体中的关键作用。
Chronic pain is a pervasive condition that is complicated by economic, educational, and racial disparities. This study analyzes key factors associated with chronic pain within an understudied and underserved population. The sample is characterized by a triple disparity with respect to income, education/literacy, and racial barriers that substantially increase the vulnerability to the negative consequences of chronic pain. The study examined the pretreatment data of 290 participants enrolled in the Learning About My Pain trial, a randomized controlled comparative effectiveness trial of psychosocial interventions (B.E.T., Principal Investigator, Patient-Centered Outcomes Research Institute Contract No. 941; clinicaltrials.gov identifier NCT01967342) for chronic pain. Hierarchical multiple regression analyses evaluated the relationships among sociodemographic (sex, age, race, poverty status, literacy, and education level) and psychological (depressive symptoms and pain catastrophizing) variables and pain interference, pain severity, and disability. The indirect effects of depressive symptoms and pain catastrophizing on the sociodemographic and pain variables were investigated using bootstrap resampling. Reversed mediation models were also examined. Results suggested that the experience of chronic pain within this low-income sample is better accounted for by psychological factors than sex, age, race, poverty status, literacy, and education level. Depressive symptoms and pain catastrophizing mediated the relationships between age and pain variables, whereas pain catastrophizing mediated the effects of primary literacy and poverty status. Some reversed models were equivalent to the hypothesized models, suggesting the possibility of bidirectionality. Although cross-sectional findings cannot establish causality, our results highlight the critical role psychological factors play in individuals with chronic pain and multiple health disparities.