Perceived Injustice Helps Explain the Association Between Chronic Pain Stigma and Movement-Evoked Pain in Adults with Nonspecific Chronic Low Back Pain.
Perceived Injustice Helps Explain the Association Between Chronic Pain Stigma and Movement-Evoked Pain in Adults with Nonspecific Chronic Low Back Pain.
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感知到的不公正有助于解释患有非特异性慢性腰痛的成年人的慢性疼痛耻辱与运动诱发的疼痛之间的关联。
DOI：
10.1093/pm/pnaa095
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Goodin,BurelR
中科院分区：
文献类型：
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作者：
Penn,TerenceM;Overstreet,DemarioS;Aroke,EdwinN;Rumble,DeannaD;Sims,AndrewM;Kehrer,CarolineV;Michl,AvaN;Hasan,FarihaN;Quinn,TammieL;Long,DLeann;Trost,Zina;Morris,MatthewC;Goodin,BurelR
对于大多数慢性下腰痛（cLBP）患者来说，原因是“非特异性的”，这意味着疼痛与脊柱或相关组织的可识别病理之间没有明确的联系。外行和提供者都不太倾向于帮助，同情心较弱，更不喜欢患者，怀疑欺骗，并将较低的疼痛严重程度归因于疼痛在组织病理学中没有客观基础的患者。由于其他人的这些污名化反应，cLBP患者可能会觉得他们的疼痛特别不公正和不公平。这些疼痛相关的不公正的看法，随后可能会导致更大的cLBP的严重程度。本研究的目的是检查是否感知不公正有助于解释慢性疼痛耻辱感和运动诱发疼痛严重程度之间的关系与cLBP individuals.MethodsParticipants包括105例cLBP患者谁完成问卷评估慢性疼痛耻辱感和疼痛相关的不公正的看法，以及用于评估运动的短期身体表现电池-结果发现，感知不公正显着介导慢性疼痛污名和cLBP严重程度之间的关联（间接效应= 6.64，95%置信区间[CI] = 2.041至14.913）和身体功能（间接效应=-0.401，95% CI =-1.029至-0.052）。更大的慢性疼痛的耻辱感与更大的感知不公正（P= 0.001），这反过来又与更大的运动诱发的疼痛严重程度（P= 0.003）。ConclusionsThese结果表明，感知不公正可能是一种手段，通过慢性疼痛的耻辱感影响非特异性cLBP的严重程度和身体功能。
ObjectiveFor most patients with chronic low back pain (cLBP), the cause is “nonspecific,” meaning there is no clear association between pain and identifiable pathology of the spine or associated tissues. Laypersons and providers alike are less inclined to help, feel less sympathy, dislike patients more, suspect deception, and attribute lower pain severity to patients whose pain does not have an objective basis in tissue pathology. Because of these stigmatizing responses from others, patients with cLBP may feel that their pain is particularly unjust and unfair. These pain-related injustice perceptions may subsequently contribute to greater cLBP severity. The purpose of this study was to examine whether perceived injustice helps explain the relationship between chronic pain stigma and movement-evoked pain severity among individuals with cLBP.MethodsParticipants included 105 patients with cLBP who completed questionnaires assessing chronic pain stigma and pain-related injustice perception, as well as a short physical performance battery for the assessment of movement-evoked pain and physical function.ResultsFindings revealed that perceived injustice significantly mediated the association between chronic pain stigma and cLBP severity (indirect effect = 6.64, 95% confidence interval [CI] = 2.041 to 14.913) and physical function (indirect effect = −0.401, 95% CI = −1.029 to −0.052). Greater chronic pain stigma was associated with greater perceived injustice (P= 0.001), which in turn was associated with greater movement-evoked pain severity (P= 0.003).ConclusionsThese results suggest that perceived injustice may be a means through which chronic pain stigma impacts nonspecific cLBP severity and physical function.