Presurgical sleep and pain behaviors predict insomnia symptoms and pain after total knee arthroplasty: a 12-month longitudinal, observational study.
Presurgical sleep and pain behaviors predict insomnia symptoms and pain after total knee arthroplasty: a 12-month longitudinal, observational study.
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术前睡眠和疼痛行为可预测全膝关节置换术后的失眠症状和疼痛：一项为期 12 个月的纵向观察性研究。
DOI：
10.1093/pm/pnad106
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Smith,MichaelT
中科院分区：
文献类型：
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作者：
Owens,MichaelA;Mun,ChungJung;Hamilton,KatrinaR;Hughes,Abbey;Campbell,ClaudiaM;Edwards,RobertR;Smith,MichaelT
接受全膝关节置换术（TKA）的患者中，高达40%的人在手术后会经历一定程度的疼痛。术前失眠已被确定为术后疼痛的预测因子，然而，与失眠相关的可改变的术前行为却很少受到关注。本研究的目的是开发一个2项睡眠和疼痛行为量表（SP2），调查适应不良的睡眠和疼痛行为，是一个较大的，家长study.MethodsPatients（N= 109）完成SP2在基线和12个月，问卷评估睡眠和疼痛在基线（前TKA），6周，3，6，和12个月后TKA的二次分析。SP2显示了足够的初步心理测量学特性。ResultsAs hypothesized，即使在控制了基线失眠、疼痛、焦虑和其他协变量后，基线SP2预测了6周时失眠症状的严重程度TKA术后6周（β = 6.722）、3个月（β = 2.140）、6个月（β = 2.962）和12个月（β = 1.835）时疼痛（P<0.05）。TKA术后6周的不适症状介导了术前SP2对术后3周疼痛的影响。（95% CI：0.024-7.054），6（95%CI：0.495-5.243）和12个月（95%置信区间：0.077-2.684）。结论这提供了初步证据，表明通过卧床和卧室来科普疼痛的患者有更高的术后疼痛发生率。手术失眠和疼痛，并支持努力针对这种适应不良的睡眠和疼痛行为，以减少术后疼痛。
ObjectiveUp to 40% of individuals who undergo total knee arthroplasty (TKA) experience some degree of pain following surgery. Presurgical insomnia has been identified as a predictor of postsurgical pain; however, modifiable presurgical behaviors related to insomnia have received minimal attention. The objective of the present study was to develop a 2-item sleep and pain behavior scale (SP2) to investigate a maladaptive sleep and pain behavior and is a secondary analysis of a larger, parent study.MethodsPatients (N= 109) completed SP2 at baseline and 12 months and questionnaires assessing sleep and pain at baseline (pre-TKA), 6 weeks, 3, 6, and 12 months post-TKA. SP2 demonstrated adequate preliminary psychometric properties.ResultsAs hypothesized, even after controlling for baseline insomnia, pain, anxiety and other covariates, baseline SP2 predicted insomnia symptom severity at 6 weeks (β = 2.828), 3 (β = 2.140), 6 (β = 2.962), and 12 months (β = 1.835) and pain at 6 weeks (β = 6.722), 3 (β = 5.536), and 6 months (β = 7.677) post-TKA (P< .05). Insomnia symptoms at 6-weeks post-TKA mediated the effect of presurgical SP2 on pain at 3 (95% CI: 0.024–7.054), 6 (95%CI: 0.495–5.243), and 12 months (95% CI: 0.077–2.684).ConclusionsThis provides preliminary evidence that patients who cope with pain by retiring to their bed and bedroom have higher rates of post-surgical insomnia and pain and supports efforts to target this maladaptive sleep and pain behavior to reduce postsurgical pain.