Dobkin Patricia L, De Civita Mirella, Abrahamowicz Michal, Baron Murray, Bernatsky Sasha
Division of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada.
Int J Behav Med. 2006;13(2):101-8. doi: 10.1207/s15327558ijbm1302_1.
Although cross-sectional studies have identified correlates of dysfunction in fibromyalgia (FM) patients (e.g., psychological distress and pain), predictors of health status have not been previously investigated using a longitudinal research design. We gathered data from 156 women who met American College of Rheumatology criteria for primary FM recruited from both tertiary care and community settings. Stepwise multiple linear regression analysis indicated that poorer health status (p < .0001) and more comorbidity (p = .0089) at baseline were predictors of poorer health status 6 months later. After controlling for these covariates, psychological distress contributed significantly to the model (p = .01). There was a trend indicating that palliative coping styles (i.e., self-care, energy conservation) altered the impact of pain on 6-month health status (p = .06). These findings highlight the need for multidisciplinary interventions that target psychological distress, coping, and comorbidity in patients with FM.
尽管横断面研究已经确定了纤维肌痛(FM)患者功能障碍的相关因素(如心理困扰和疼痛),但此前尚未使用纵向研究设计对健康状况的预测因素进行调查。我们收集了156名符合美国风湿病学会原发性FM标准的女性的数据,这些女性是从三级医疗和社区环境中招募的。逐步多元线性回归分析表明,基线时较差的健康状况(p < .0001)和更多的合并症(p = .0089)是6个月后健康状况较差的预测因素。在控制了这些协变量后,心理困扰对模型有显著贡献(p = .01)。有一个趋势表明,姑息性应对方式(即自我护理、保存精力)改变了疼痛对6个月健康状况的影响(p = .06)。这些发现凸显了针对FM患者的心理困扰、应对方式和合并症进行多学科干预的必要性。