The Problem of Pain in Systemic Lupus Erythematosus: An Explication of the Role of Biopsychosocial Mechanisms.
The Problem of Pain in Systemic Lupus Erythematosus: An Explication of the Role of Biopsychosocial Mechanisms.
复制标题
DOI：
10.3899/jrheum.200595
复制
发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Lim SS
中科院分区：
文献类型：
--
作者：
Falasinnu T;Drenkard C;Bao G;Mackey S;Lim SS
明确系统性红斑狼疮（SLE）患者疼痛的生物心理社会机制，这些机制超越疾病活动和器官损害。我们对766例SLE患者进行了一项以人群为基础的登记研究，对患者报告的数据进行了横断面分析。疼痛强度和干扰的预测因素采用分层线性回归进行了研究。我们建立了两个主要的分层回归模型：疼痛强度对疾病活动和器官损伤的回归;疼痛干扰对疾病活动和器官损伤的回归。对于每个模型，我们试图建立疼痛结果和主要暴露之间的关系，使用顺序步骤，包括在六个阶段中包含每个结构：人口统计学，社会经济学，物理，心理，行为和社会因素。我们还进行了敏感性分析，消除了疾病活动性测量中疼痛的所有明显方面，并重新估计了模型。疾病活动和器官损伤解释了32-33%的疼痛强度和干扰的方差。社会人口因素占疼痛结果方差的另外4-9%，而心理社会/行为因素占方差的最后4%。在敏感性分析中，我们发现疾病活动和器官损伤解释了25%的疼痛结果方差。疾病活动仅解释了疼痛结果变异的33%。然而，在考虑了心理/行为因素后，这些相关性有所减弱，突出了它们在改变疾病活动与疼痛之间关系方面的作用。这些研究结果表明，可能需要多层次的干预措施来解决疼痛对SLE的负面影响。
To define biopsychosocial mechanisms of pain that go above and beyond disease activity and organ damage in systemic lupus erythematosus (SLE). We conducted a cross-sectional analysis of patient-reported data in a population-based registry of 766 people with SLE. Predictors of pain intensity and interference were examined using hierarchical linear regression. We built two main hierarchical regression models: pain intensity regressed on disease activity and organ damage; and pain interference regressed on disease activity and organ damage. For each model, we sought to establish the relationship between pain outcomes and the primary exposures using sequential steps comprising the inclusion of each construct in six stages: demographic, socioeconomic, physical, psychological, behavioral and social factors. We also conducted sensivity analyses eliminating all overt aspects of pain in the disease activity measure and reestimated the models. Disease activity and organ damage explained 32–33% of the variance in pain intensity and interference. Sociodemographic factors accounted for an additional 4–9% of variance in pain outcomes, while psychosocial/behavioral factors accounted for the final 4% of variance. In the sensitivity analyses, we found that disease activity and organ damage explained 25% of the variance in pain outcomes. Disease activity only explained 33% of the variance of pain outcomes. However, there was an attenuation in these associations after accounting for psychosocial/behavioral factors, highlighting their roles in modifying the relationship between disease activity and pain. These findings suggest that multilevel interventions may be needed to tackle the negative impact of pain in SLE.
登录
查看更多内容
影响因子：
2.9
作者：
Booker, Staja Q.;Sibille, Kimberly T.;Bartley, Emily J.
通讯作者：
Bartley, Emily J.
影响因子：
4.7
作者：
Lillis, Teresa A.;Tirone, Vanessa;Jolly, Meenakshi
通讯作者：
Jolly, Meenakshi
影响因子：
7.4
作者：
Heitmann, Henrik;Haller, Bernhard;Ploner, Markus
通讯作者：
Ploner, Markus
影响因子：
3.4
作者：
Chaiamnuay, Sumapa;Bertoli, Ana M.;Alarcon, Graciela S.
通讯作者：
Alarcon, Graciela S.
影响因子：
4.7
作者：
Drenkard, Cristina;Bao, Gaobin;Lim, S. Sam
通讯作者：
Lim, S. Sam