Mäntyselkä Pekka T, Turunen Juha H O, Ahonen Riitta S, Kumpusalo Esko A
Department of Public Health and General Practice, University of Kuopio and Unit of General Practice, Kuopio University Hospital, Finland.
JAMA. 2003 Nov 12;290(18):2435-42. doi: 10.1001/jama.290.18.2435.
Chronic pain is common in Western societies. Self-rated health is an important indicator of morbidity and mortality, but little is known about the relation between chronic pain and self-rated health in the general population.
To analyze the association between chronic pain and self-rated health.
DESIGN, SETTING, AND POPULATION: A questionnaire survey carried out during the spring of 2002 of an age- and sex-stratified population sample of 6500 individuals in Finland aged 15 to 74 years, with a response rate of 71% (N = 4542) after exclusion of those with unobtainable data (n = 38). Chronic pain was defined as pain with a duration of at least 3 months and was graded by frequency: (1) at most once a week; (2) several times a week; and (3) daily or continuously. On the basis of a 5-item questionnaire on self-rated health, individuals were classified as having good, moderate, or poor health. Multinominal logistic regression analysis was used to assess the determinants of health. Analysis included sex, age, education, working status, chronic diseases, and mood.
Perceived chronic pain graded by frequency and self-rated health status.
The prevalence of any chronic pain was 35.1%; that of daily chronic pain, 14.3%. The prevalence of moderate self-rated health was 26.6% and of poor health, 7.6%. For moderate self-rated health among individuals having chronic pain at most once a week compared with individuals having no chronic pain, the adjusted odds were 1.36 (95% confidence interval [CI], 1.05-1.76); several times a week, 2.41 (95% CI, 1.94-3.00); and daily, 3.69 (95% CI, 2.97-4.59). Odds for poor self-rated health were as follows: having chronic pain at most once a week, 1.16 (95% CI, 0.65-2.07); several times a week, 2.62 (95% CI, 1.76-3.90); and daily, 11.82 (95% CI, 8.67-16.10).
Chronic pain is independently related to low self-rated health in the general population.
慢性疼痛在西方社会很常见。自评健康状况是发病率和死亡率的一项重要指标，但对于普通人群中慢性疼痛与自评健康之间的关系却知之甚少。
分析慢性疼痛与自评健康之间的关联。
设计、地点和人群：于2002年春季对芬兰6500名年龄在15至74岁之间的按年龄和性别分层的人群样本进行了问卷调查，在排除数据无法获取者（n = 38）后，应答率为71%（N = 4542）。慢性疼痛定义为持续时间至少3个月的疼痛，并按频率分级：（1）每周至多一次；（2）每周几次；（3）每天或持续存在。根据一份关于自评健康状况的5项问卷，将个体分为健康状况良好、中等或较差。采用多项逻辑回归分析来评估健康状况的决定因素。分析包括性别、年龄、教育程度、工作状态、慢性病和情绪。
按频率分级的感知慢性疼痛和自评健康状况。
任何慢性疼痛的患病率为35.1%；每日慢性疼痛的患病率为14.3%。自评健康状况中等的患病率为26.6%，健康状况较差的患病率为7.6%。与无慢性疼痛的个体相比，每周至多有一次慢性疼痛的个体自评健康状况中等的调整优势比为1.36（95%置信区间[CI]，1.05 - 1.76）；每周几次为2.41（95% CI，1.94 - 3.00）；每天为3.69（95% CI，2.97 - 4.59）。自评健康状况较差的优势比如下：每周至多有一次慢性疼痛为1.16（95% CI，0.65 - 2.07）；每周几次为2.62（95% CI，1.76 - 3.90）；每天为11.82（95% CI，8.67 - 16.10）。
在普通人群中，慢性疼痛与自评健康状况不佳独立相关。
