Pells Jennifer, Edwards Christopher L, McDougald Camela S, Wood Mary, Barksdale Crystal, Jonassaint Jude, Leach-Beale Brittani, Byrd Goldie, Mathis Markece, Harrison Myleme O, Feliu Miriam, Edwards Lekisha Y, Whitfield Keith E, Rogers Lesco
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.
Clin J Pain. 2007 Oct;23(8):707-13. doi: 10.1097/AJP.0b013e31814da3eb.
Fear of movement (ie, kinesiophobia) has emerged as a significant predictor of pain-related outcomes including disability and psychologic distress across various types of pain (eg, back pain, headache, fibromyalgia, complex regional pain syndrome). However, no research has examined the prevalence of kinesiophobia in adults with sickle cell disease (SCD). The purpose of this study was to assess the degree of kinesiophobia reported by African American men and women with SCD and to determine whether kinesiophobia is related to pain and psychologic distress in this population.
Sixty-seven men and women with SCD recruited from a comprehensive sickle cell treatment program in a large academic medical center completed questionnaires that assess fear of movement, pain and pain interference, and psychologic distress.
Participants reported levels of kinesiophobia (M=30.48, SD=7.55) that were comparable to those obtained for patients with low back pain and fibromyalgia. Although pain levels did not differ by sex, men reported greater kinesiophobia than women (P=0.02). As hypothesized, higher levels of kinesiophobia were associated with greater psychologic distress, particularly Phobic Anxiety (r=0.35), Psychoticism (r=0.29), Somatization (r=0.45), Anxiety (r=0.35), Obsessive-compulsive (r=0.34), Interpersonal Sensitivity (r=0.25), Depression (r=0.29), and all 3 summary indices of the SCL-90-R (all Ps<0.05).
Although and historically, pain associated with SCD has not been considered in the context of fear of movement, findings suggest that both kinesiophobia and sex are relevant constructs for consideration in understanding pain-related outcomes in SCD. Though our results require replication, this study suggests that greater kinesiophobia is associated with greater pain and psychologic distress.
对运动的恐惧(即运动恐惧症)已成为疼痛相关结果的重要预测指标,包括各种类型疼痛(如背痛、头痛、纤维肌痛、复杂性区域疼痛综合征)患者的残疾和心理困扰。然而,尚无研究调查镰状细胞病(SCD)成人患者中运动恐惧症的患病率。本研究的目的是评估患有SCD的非裔美国男性和女性报告的运动恐惧症程度,并确定运动恐惧症是否与该人群的疼痛和心理困扰相关。
从一家大型学术医疗中心的综合性镰状细胞治疗项目中招募了67名患有SCD的男性和女性,他们完成了评估运动恐惧、疼痛及疼痛干扰和心理困扰的问卷。
参与者报告的运动恐惧症水平(M = 30.48,SD = 7.55)与腰痛和纤维肌痛患者的水平相当。尽管疼痛水平无性别差异,但男性报告的运动恐惧症高于女性(P = 0.02)。如假设的那样,更高水平的运动恐惧症与更大的心理困扰相关,特别是恐惧焦虑(r = 0.35)、精神质(r = 0.29)、躯体化(r = 0.45)、焦虑(r = 0.35)、强迫(r = 0.34)、人际敏感(r = 0.25)、抑郁(r = 0.29)以及SCL - 90 - R的所有3个总结指标(所有P值<0.05)。
尽管从历史上看,与SCD相关的疼痛未在运动恐惧的背景下进行考虑,但研究结果表明,运动恐惧症和性别都是理解SCD中疼痛相关结果时需要考虑的相关因素。尽管我们的结果需要重复验证,但本研究表明,更高水平的运动恐惧症与更大的疼痛和心理困扰相关。