Factors Associated with Higher Reported Pain Levels in Patients with Chronic Musculoskeletal Pain: A Cross-Sectional, Correlational Analysis
Factors Associated with Higher Reported Pain Levels in Patients with Chronic Musculoskeletal Pain: A Cross-Sectional, Correlational Analysis
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DOI：
10.1371/journal.pone.0163132
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发表时间：
2016-09-16
期刊：
影响因子：
3.7
通讯作者：
Kim, Shin Hyung
中科院分区：
文献类型：
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作者：
Park, Sang Jun;Yoon, Duck Mi;Kim, Shin Hyung
背景慢性肌肉骨骼疼痛是一种非常普遍、致残、昂贵的疾病，对生活质量有许多负面影响。本研究的目的是在人口统计学、临床和心理因素中调查与慢性肌肉骨骼疼痛患者报告的疼痛水平较高相关的因素，并评估失眠是否与该人群的疼痛强度独立相关。方法357例慢性肌肉骨骼疼痛患者，（疼痛持续时间>= 6个月）符合研究纳入标准，并纳入分析。患者的人口统计学、临床和心理因素采用分层多变量逻辑分析进行评估，以确定与重度疼痛相关的因素（NRS [数字评定量表] >= 7）。分层线性回归分析也进行了识别与疼痛强度相关的因素结果多因素logistic分析显示年龄较大（OR [比值比] = 1.017，95%CI [置信区间] 1.001-1.032，P = 0.034），高焦虑水平（OR = 1.162，95%CI 1.020-1.324，P = 0.024），高度疼痛灾难性（OR = 1.043，95% CI 1.007-1.081，P = 0.018）、重度失眠（OR = 1.112，95% CI 1.057-1.170，P < 0.001）与重度疼痛显著相关。分层线性回归分析显示，年龄（β = 0.106，P = 0.041）、疼痛灾难化（β = 0.249，P< 0.001）和失眠（β = 0.286，P < 0.001）与疼痛强度显著相关。最终模型解释的疼痛强度差异为32.2%.ConclusionsOlder age，severe insomnia，and high pain catastrophizing are significantly associated with higher reported pain levels.即使在控制了各种人口统计学和临床因素后，Increase与疼痛强度独立相关。在为这一人群制定疼痛管理策略时，应考虑这些因素。
BackgroundChronic musculoskeletal pain is highly prevalent, disabling, and costly, and has many negative effects on quality of life. The aim of this study was to investigate factors associated with higher reported pain levels in patients with chronic musculoskeletal pain among demographic, clinical, and psychological factors, and to evaluate whether insomnia is independently associated with pain intensity in this population.MethodsA total of 357 patients with chronic musculoskeletal pain (pain duration >= six months) satisfied the study inclusion criteria and were included in the analyses. Patient demographics, clinical, and psychological factors were evaluated with hierarchical multivariate logistic analysis to identify factors associated with severe pain (NRS [numeric rating scale] >= 7). Hierarchical linear regression analysis also performed to identify factors associated with pain intensity (0 to 10 NRS).ResultsMultivariate logistic analyses revealed older age (OR [odds ratio] = 1.017, 95% CI [confidence interval] 1.001-1.032, P = 0.034), high anxiety level (OR = 1.162, 95% CI 1.020-1.324, P = 0.024), high pain catastrophizing (OR = 1.043, 95% CI 1.007-1.081, P = 0.018), and severe insomnia (OR = 1.112, 95% CI 1.057-1.170, P < 0.001) were significantly associated with severe pain. Hierarchical linear regression analysis showed age (beta = 0.106, P = 0.041), pain catastrophizing (beta = 0.249, P< 0.001), and insomnia (beta = 0.286, P < 0.001) were significantly associated with pain intensity. The variance in pain intensity explained by the final model was 32.2%.ConclusionsOlder age, severe insomnia, and high pain catastrophizing were significantly associated with higher reported pain levels. Insomnia was independently associated with pain intensity, even after controlling for various demographic and clinical factors. These factors should be considered when devising pain management strategies for this population.