Within-Day Variability of Fatigue and Pain Among African Americans and Non-Hispanic Whites With Osteoarthritis of the Knee.
Within-Day Variability of Fatigue and Pain Among African Americans and Non-Hispanic Whites With Osteoarthritis of the Knee.
复制标题
患有膝骨关节炎的非裔美国人和非西班牙裔白人的疲劳和疼痛的日内变化。
DOI：
10.1002/acr.22690
复制
发表时间：
2016
影响因子：
4.7
通讯作者：
Parmelee,PatriciaA
中科院分区：
文献类型：
--
作者：
Smith,DylanM;Parmelee,PatriciaA
疲劳在骨关节炎（OA）患者中很常见，但对OA患病率、相关性或疲劳动态的种族/民族差异知之甚少。因此，本研究使用经验抽样方法（ESM）来检查非裔美国人和非西班牙裔白人OA患者的整体和瞬间水平的疲劳和疼痛。方法39名非裔美国人和81名非西班牙裔白人医生诊断为膝关节OA，完成了基线访谈和ESM方案，评估疲劳、疼痛和情绪，每天4次，持续7天。除了分析基本的组间差异外，多层模型还检查了受试者内部与受试者之间的模式以及瞬时疲劳变异性的相关性，控制了人口统计学和其他潜在的混杂因素。结果两个种族的人都经历了中等程度的疲劳；然而，在瞬时评估中，平均疲劳水平和变异性都存在明显的个体差异。平均疲劳程度与全身疼痛和抑郁有关。非西班牙裔白人比非裔美国人在一天的工作中更容易感到疲劳。瞬时疲劳与疼痛密切相关。平均疲劳预测了情绪的变化；在瞬间水平上，疲劳和疼痛都与情绪独立相关。结论疲劳是非裔美国人和非西班牙裔白人骨性关节炎患者的重要因素，且与生活质量呈负相关。疼痛症状，无论是在瞬间水平还是在个体之间，都是疲劳的有力预测指标。尽管这两组报告的总体症状水平相似，但一天中疲劳症状的模式不同。
ObjectiveFatigue is common among persons with osteoarthritis (OA), but little is known about racial/ethnic differences in the prevalence, correlates, or dynamics of fatigue in OA. This research therefore used experience sampling methodology (ESM) to examine fatigue and pain at global and momentary levels among African Americans and non‐Hispanic whites with OA.MethodsThirty‐nine African Americans and 81 non‐Hispanic whites with physician‐diagnosed knee OA completed a baseline interview and an ESM protocol assessing fatigue, pain, and mood 4 times daily for 7 days. In addition to analyzing basic group differences, multilevel modeling examined within‐ versus between‐subject patterns and correlates of variability in momentary fatigue, controlling for demographics and other potential confounders.ResultsBoth racial groups experienced moderate levels of fatigue; however, there were clear individual differences in both mean fatigue level and variability across momentary assessments. Mean fatigue levels were associated with global pain and depression. Increase in fatigue over the course of the day was much stronger among non‐Hispanic whites than African Americans. Momentary fatigue and pain were closely correlated. Mean fatigue predicted variability in mood; at the momentary level, both fatigue and pain were independently associated with mood.ConclusionFatigue is a significant factor for both African Americans and non‐Hispanic whites with OA, and is negatively related to quality of life. Pain symptoms, at both the momentary level and across individuals, were robust predictors of fatigue. Although overall levels of reported symptoms were similar across these 2 groups, the pattern of fatigue symptoms across the day differed.