The relationship between physical functional limitations, and psychological distress: Considering a possible mediating role of pain, social support and sense of mastery.
The relationship between physical functional limitations, and psychological distress: Considering a possible mediating role of pain, social support and sense of mastery.
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DOI：
10.1016/j.ssmph.2017.12.005
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发表时间：
2018-04
期刊：
影响因子：
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通讯作者：
Clench-Aas J
中科院分区：
文献类型：
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作者：
Backe IF;Patil GG;Nes RB;Clench-Aas J
本研究的目的是检查与日常活动有关的选定的身体功能限制与心理困扰之间的联系。我们还旨在调查这些关联是否因年龄而异（适度），并探索疼痛、掌控感和社会支持作为潜在的调节和中介。该研究基于两轮（2008年和2012年）挪威全国代表性横断面健康调查（N = 8520）的汇总数据，包括年龄≥16岁的个体（年龄组= 16 - 44岁和≥45岁）。身体功能限制包括：i)爬楼梯的能力下降，ii)搬运物品的能力下降，或iii)两者都有。心理困扰以单独或合并出现的焦虑和抑郁症状（CAD）来衡量。在报告身体功能限制的受访者中，8-14%报告抑郁症状，5-7%报告焦虑症状，13-28%报告CAD。身体功能限制与所有三种形式的心理困扰显著相关，特别是在16-44岁的个体中，并且与CAD的相关性比单独发生的焦虑或抑郁更强。当两种类型的身体功能限制都存在时，与CAD的关联是其两倍强。疼痛、掌握感和社会支持是抑郁的显著调节因子，而三者都是身体功能限制与焦虑、抑郁和CAD之间关系的显著中介因子。掌握感在身体功能限制与CAD的关系中起中介作用，但在16-44岁年龄组中作用最强。社会支持仅在45年之间具有显著的中介作用。身体功能限制和心理困扰之间的密切联系突出了经历日常功能限制的个体的特殊需求。研究结果还表明，疼痛、低社会支持和低掌控感可能会加剧心理困扰。身体功能限制与心理困扰有关。年轻人在心理上更容易受到功能限制的困扰。掌控感既是调节者，也是调解者。疼痛是一个重要的中介。
The aim of this study was to examine associations between selected physical functional limitations related to performing daily activities and psychological distress. We also aimed to investigate if these associations vary across age (moderation), and to explore pain, sense of mastery and social support as potential moderators and mediators. The study was based on pooled data from two rounds (2008 and 2012) of a Norwegian nationally representative cross-sectional health survey (N = 8520) including individuals aged ≥ 16 years (Age groups = 16–44 and ≥ 45 years). Physical functional limitations comprised decreased ability to: i) climb stairs, ii) carry objects, or iii) both. Psychological distress was measured as anxiety and depressive symptoms occurring separately or in combination (CAD). Of respondents reporting physical functional limitations, 8–14% reported depressive symptoms, 5–7% anxiety symptoms, and 13–28% reported CAD. Physical functional limitations were significantly associated with all three forms of psychological distress, particularly among individuals 16–44 years, and were more strongly related to CAD than to anxiety or depression occurring separately. The association with CAD was twice as strong when both types of physical functional limitations were present. Pain, sense of mastery and social support were significant modifiers of depression, whereas all three were significant mediators of the relationship between physical functional limitations and anxiety, depression and CAD. Sense of mastery mediated the relationship between physical functional limitations and CAD, but most strongly among those 16–44 years. Social support was only a significant mediator among those 45 years. Close associations between physical functional limitations and psychological distress highlight special needs among individuals experiencing daily functional limitations. The results also suggest that pain, low social support, and low sense of mastery may contribute to aggravate psychological distress. Physical functional limitations were associated with psychological distress. Younger individuals were more psychologically distressed by functional limitations. Sense of mastery was both a moderator and mediator. Pain was an important mediator.