Hagen K B, Bjørndal A, Uhlig T, Kvien T K
Department of Population Health Sciences, National Institute of Public Health, Oslo, Norway.
Ann Rheum Dis. 2000 Oct;59(10):788-93. doi: 10.1136/ard.59.10.788.
To investigate factors associated with visiting a general practitioner (GP) for non-inflammatory musculoskeletal pain, and to examine whether these factors were affected by duration (chronic v non-chronic) or location (widespread v regional) of pain.
From a cross sectional postal survey of 20 000 (response rate 59%) randomly selected adults in two counties of Norway, 6408 subjects who had experienced musculoskeletal pain during the past month were included. Patients who reported inflammatory rheumatic diagnoses made by a doctor were excluded.
2909 (45%) had consulted a GP for their musculoskeletal pain during the past 12 months. The odds of consulting were significantly increased by being a woman, by having a higher age and lower education, and by being a pensioner or on sick leave. Patients with widespread pain were more likely to consult than those with regional pain, as were patients with chronic compared with non-chronic pain. Greater than median pain intensity was the factor most prominently associated with consultation for men (odds ratio (OR)=2.4; 95% confidence interval (95% CI) 2.0 to 2.9) and for women (OR=2.6; 95% CI 2.3 to 2.9). Overall, consultation was significantly associated with mental distress for women but not for men. Subgroup analyses showed that consultation for chronic pain was significantly associated with greater than median mental distress for both women (OR=1.3; 95% CI 1.1 to 1.6) and men (OR=1.2; 95% CI 1. 0 to 1.4), whereas consultation for non-chronic pain was not.
The results show that about half of the patients with musculoskeletal pain consult a general practitioner (GP) each year, that demographic factors are associated with consulting, and that the role of mental distress for consulting a GP varies with duration of pain.
调查与因非炎性肌肉骨骼疼痛就诊于全科医生（GP）相关的因素，并检查这些因素是否受疼痛持续时间（慢性与非慢性）或疼痛部位（广泛性与局限性）的影响。
从挪威两个县对20000名随机选取的成年人进行的横断面邮寄调查（回复率59%）中，纳入了在过去一个月内经历过肌肉骨骼疼痛的6408名受试者。排除报告有医生诊断的炎性风湿性疾病的患者。
在过去12个月中，2909名（45%）因肌肉骨骼疼痛咨询过全科医生。女性、年龄较大、教育程度较低、退休人员或病假人员咨询的几率显著增加。广泛性疼痛患者比局限性疼痛患者更有可能咨询，慢性疼痛患者比非慢性疼痛患者更有可能咨询。疼痛强度大于中位数是男性（优势比（OR）=2.4；95%置信区间（95%CI）2.0至2.9）和女性（OR=2.6；95%CI 2.3至2.9）咨询最显著相关的因素。总体而言，咨询与女性的心理困扰显著相关，而与男性无关。亚组分析表明，慢性疼痛的咨询与女性（OR=1.3；95%CI 1.1至1.6）和男性（OR=1.2；95%CI 1.0至1.4）大于中位数的心理困扰显著相关，而非慢性疼痛的咨询则不然。
结果表明，每年约有一半的肌肉骨骼疼痛患者咨询全科医生，人口统计学因素与咨询有关，心理困扰对咨询全科医生的作用因疼痛持续时间而异。
