Family dysfunction is associated with chronic pain in a community- dwelling Japanese population: The Hisayama study
Family dysfunction is associated with chronic pain in a community- dwelling Japanese population: The Hisayama study
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家庭功能障碍与日本社区居民的慢性疼痛有关：久山研究
作者：
Saito T;Shibata M;Hirabayashi N;Honda T;Morisaki Y;Anno K;Sudo N;Hosoi M;Ninomiya T
背景：据报道，家庭功能不佳与门诊患者慢性疼痛的严重程度有关，但这种关联尚未在普通人群中得到充分解决。本研究旨在研究日本社区居民家庭功能障碍水平与慢性疼痛之间的关系。方法2598名年龄≥40岁的参与者被分为健康、边缘性和不健康的家庭功能。慢性疼痛定义为持续三个月或更长时间的主观疼痛，并根据疼痛强度、慢性疼痛部位数量、疼痛持续时间和疼痛扩散程度进一步分类。使用逻辑回归模型计算慢性疼痛结局的优势比（ORs）。结果慢性疼痛发生率为49%。随着家庭功能障碍水平的增加，经年龄和性别调整的总疼痛和重度慢性疼痛患病率显著增加（趋势均<0.01）。在调整了社会人口学、生理、社会和家庭结构因素后，与健康家庭功能组相比，边缘组和不健康组慢性疼痛的or（95%置信区间[CI]）分别为1.20（1.01-1.44）和1.43（1.15-1.79）。这种联系在有工作的人和与孩子同住的人中更为明显。此外，严重慢性疼痛的ORs随着家庭功能障碍水平的增加而显著增加。结论家庭功能障碍水平与社区居民慢性疼痛的存在和严重程度呈正相关。意义家庭关系引起的生物心理社会负担可加重疼痛的临床表现。对功能失调家庭的社会支持或家庭治疗将是预防或管理慢性疼痛的潜在举措。
BackgroundPoor family functioning has been reported to be associated with the severity of chronic pain in outpatients, but the association has not been fully addressed in general populations. The present study aimed to examine the association between family dysfunction levels and the presence of chronic pain in a community‐dwelling Japanese population.MethodsA total of 2598 participants aged ≥40 years were classified as having healthy, borderline or unhealthy family functioning. Chronic pain was defined as subjective pain for three months or longer, and further classified by pain intensity, the number of chronic pain sites, pain duration and the extent of pain spread. A logistic regression model was used to compute the odds ratios (ORs) for chronic pain outcomes.ResultsThe prevalence of chronic pain was 49%. The age‐ and sex‐adjusted prevalence of total and severe chronic pain were increased significantly with increasing family dysfunction levels (allpfor trend <0.01). After adjusting for sociodemographic, physical, social and family structure factors, the ORs (95% confidence intervals [CI]) for having chronic pain among borderline and unhealthy groups were 1.20 (1.01–1.44) and 1.43 (1.15–1.79), respectively, as compared with a healthy family function group. The association was stronger among people who were employed and those who were living with their children. In addition, the ORs for severe chronic pain increased significantly with increasing levels of family dysfunction.ConclusionsThe family dysfunction level was positively associated with the presence as well as the severity of chronic pain in a community‐dwelling population.SignificanceA biopsychosocial burden due to family relationships could worsen the clinical presentation of pain. Social support or family therapy for dysfunctional families would be a potential initiative for the prevention or management of chronic pain.