Race/Ethnicity Moderates the Association Between Psychosocial Resilience and Movement-Evoked Pain in Knee Osteoarthritis
Race/Ethnicity Moderates the Association Between Psychosocial Resilience and Movement-Evoked Pain in Knee Osteoarthritis
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DOI：
10.1002/acr2.1002
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发表时间：
2019-03-01
影响因子：
3.4
通讯作者：
Fillingim, Roger B.
中科院分区：
文献类型：
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作者：
Bartley, Emily J.;Hossain, Nadia I.;Fillingim, Roger B.
目的疼痛方面的种族/民族差异是众所周知的，非西班牙裔黑人（NHB）比非西班牙裔白人（NHW）经历更严重的疼痛严重程度和与疼痛相关的残疾。虽然许多风险因素被假定为这些差异的贡献者，但关于弹性如何不同地影响不同种族/民族的疼痛和功能的研究有限。因此，本研究探讨了膝关节骨关节炎（OA）成人患者的心理社会弹性、临床疼痛和功能表现之间的相关性，并评估了种族/民族对这些关系的调节作用。（UPLOAD-2）研究，201例膝关节OA患者（NHB = 105，NHW = 96）完成复原力措施（即，特质弹性，乐观，积极的幸福感，社会支持，积极的影响）和临床疼痛，以及性能为基础的措施评估下肢功能和运动诱发pain.ResultsBivariate分析表明，较高水平的心理社会弹性与较低的临床疼痛和残疾，更优化的身体功能。与NHWs相比，NHB报告了更大的疼痛和残疾，下肢功能较差，运动诱发疼痛更高;然而，不同种族/民族的心理社会弹性指标相似。在适度的分析，更高的乐观和积极的幸福感是保护运动诱发的疼痛NHB，而更高水平的积极影响与更大的运动诱发的疼痛NHWs.ConclusionOur研究结果强调的重要性，心理社会弹性OA相关的疼痛和功能，并强调种族/民族的影响力的疼痛关系。针对恢复力的治疗可能有助于减轻疼痛的种族/民族差异。
ObjectiveRacial/ethnic disparities in pain are well-recognized, with non-Hispanic blacks (NHBs) experiencing greater pain severity and pain-related disability than non-Hispanic whites (NHWs). Although numerous risk factors are posited as contributors to these disparities, there is limited research addressing how resilience differentially influences pain and functioning across race/ethnicity. Therefore, this study examined associations between measures of psychosocial resilience, clinical pain, and functional performance among adults with knee osteoarthritis (OA), and assessed the moderating role of race/ethnicity on these relationships.MethodsIn a secondary analysis of the Understanding Pain and Limitations in Osteoarthritic Disease (UPLOAD-2) study, 201 individuals with knee OA (NHB = 105, NHW = 96) completed measures of resilience (ie, trait resilience, optimism, positive well-being, social support, positive affect) and clinical pain, as well as a performance-based measure assessing lower-extremity function and movement-evoked pain.ResultsBivariate analyses showed that higher levels of psychosocial resilience were associated with lower clinical pain and disability and more optimal physical functioning. NHBs reported greater pain and disability, poorer lower-extremity function, and higher movement-evoked pain compared with NHWs; however, measures of psychosocial resilience were similar across race/ethnicity. In moderation analyses, higher optimism and positive well-being were protective against movement-evoked pain in NHBs, whereas higher levels of positive affect were associated with greater movement-evoked pain in NHWs.ConclusionOur findings underscore the importance of psychosocial resilience on OA-related pain and function and highlight the influence of race/ethnicity on the resilience-pain relationship. Treatments aimed at targeting resilience may help mitigate racial/ethnic disparities in pain.