The effect of chronic pain on diabetes patients' self-management
The effect of chronic pain on diabetes patients' self-management
复制标题
DOI：
10.2337/diacare.28.1.65
复制
发表时间：
2005-01-01
期刊：
影响因子：
16.2
通讯作者：
Kerr, EA
中科院分区：
文献类型：
--
作者：
Krein, SL;Heisler, M;Kerr, EA
目的：许多成年人经历慢性疼痛，但对糖尿病患者这种疼痛的后果知之甚少。本研究的目的是研究慢性疼痛是否以及如何影响糖尿病患者的自我管理。研究设计和方法：这是一项通过退伍军人事务部（VA）接受治疗的993例糖尿病患者的横断面研究。通过书面调查收集关于慢性疼痛的数据，定义为过去一年中大部分时间持续6个月或更长时间的疼痛，以及糖尿病自我管理。多变量回归技术用于检查慢性疼痛的存在和严重程度与糖尿病自我管理困难之间的关系，并根据社会人口统计学和其他健康特征（包括抑郁症）进行调整。结果：大约60%的受访者报告慢性疼痛。慢性疼痛患者的糖尿病自我管理总体较差（P = 0.002），推荐的运动计划（调整优势比[OR] 3.0 [95% Cl 2.1-4.1]）和饮食计划（1.6[1.2-2.1]）更困难。与轻度或中度疼痛患者相比，重度或极重度疼痛患者的糖尿病自我管理能力明显较差（P = 0.003），包括服用糖尿病药物（2.0[1.2-3.4]）和运动（2.5[1.3-5.0]）的难度更大。结论：慢性疼痛在该糖尿病患者队列中普遍存在。即使在控制了一般健康状况和抑郁症状之后，慢性疼痛仍然是自我保健行为表现的主要限制因素，而自我保健行为对减少糖尿病相关并发症很重要。在与患者一起制定有效的糖尿病自我保健方案时，应考虑到诸如慢性疼痛等竞争性需求。糖尿病护理28:65-70,2005。
OBJECTIVE - Many adults experience chronic pain, yet little is known about the consequences of such pain among individuals with diabetes. The purpose of this study was to examine whether and how chronic pain affects diabetes self-management.RESEARCH DESIGN AND METHODS - This is a cross-sectional study of 993 patients with diabetes receiving care through the Department of Veterans Affairs (VA). Data on chronic pain, defined as pain present most of the time for 6 months or more during the past year, and diabetes self-management were collected through a written survey. Multivariable regression techniques were used to examine the association between the presence and severity of chronic pain and difficulty with diabetes self-management, adjusting for sociodemographic and other health characteristics including depression.RESULTS - Approximately 60% of respondents reported chronic pain. Patients with chronic pain had poorer diabetes self-management overall (P = 0.002) and more difficulty following a recommended exercise plan (adjusted odds ratio [OR] 3.0 [95% Cl 2.1-4.1]) and eating plan (1.6 [1.2-2.1]). Individuals with severe or very severe pain, compared with mild or moderate, reported significantly poorer diabetes self-management (P = 0.003), including greater difficulty with taking diabetes medications (2.0 [1.2-3.4]) and exercise (2.5 [1.3-5.0]).CONCLUSIONS - Chronic pain was prevalent in this cohort of patients with diabetes. Even after controlling for general health status and depressive symptoms, chronic pain was a major limiting factor in the performance of self-care behaviors that are important for minimizing diabetes-related complications. Competing demands, such as chronic pain, should be considered when working with patients to develop effective diabetes self-care regimens.Diabetes Care 28:65-70, 2005.