颈部疼痛是否与6个月后较差的健康相关生活质量有关？一项基于人群的队列研究。 - Suppr | 超能文献

Abstract

BACKGROUND CONTEXT

Current evidence suggests that neck pain is negatively associated with health-related quality of life (HRQoL). However, these studies are cross-sectional and do not inform the association between neck pain and future HRQoL.

PURPOSE

The purpose of this study was to investigate the association between increasing grades of neck pain severity and HRQoL 6 months later. In addition, this longitudinal study examines the crude association between the course of neck pain and HRQoL.

STUDY DESIGN

This is a population-based cohort study.

PATIENT SAMPLE

Eleven hundred randomly sampled Saskatchewan adults were included.

OUTCOME MEASURES

Outcome measures were the mental component summary (MCS) and physical component summary (PCS) of the Short-Form-36 (SF-36) questionnaire.

METHODS

We formed a cohort of 1,100 randomly sampled Saskatchewan adults in September 1995. We used the Chronic Pain Questionnaire to measure neck pain and its related disability. The SF-36 questionnaire was used to measure physical and mental HRQoL 6 months later. Multivariable linear regression was used to measure the association between graded neck pain and HRQoL while controlling for confounding. Analysis of variance and t tests were used to measure the crude association among four possible courses of neck pain and HRQoL at 6 months. The neck pain trajectories over 6 months were no or mild neck pain, improving neck pain, worsening neck pain, and persistent neck pain. Finally, analysis of variance was used to examine changes in baseline to 6-month PCS and MCS scores among the four neck pain trajectory groups.

RESULTS

The 6-month follow-up rate was 74.9%. We found an exposure-response relationship between neck pain and physical HRQoL after adjusting for age, education, arthritis, low back pain, and depressive symptomatology. Compared with participants without neck pain at baseline, those with mild (β=-1.53, 95% confidence interval [CI]=-2.83, -0.24), intense (β=-3.60, 95% CI=-5.76, -1.44), or disabling (β=-8.55, 95% CI=-11.68, -5.42) neck pain had worse physical HRQoL 6 months later. We did not find an association between neck pain and mental HRQoL. A worsening course of neck pain and persistent neck pain were associated with worse physical HRQoL.

CONCLUSIONS

We found that neck pain was negatively associated with physical but not mental HRQoL. Our analysis suggests that neck pain may be a contributor of future poor physical HRQoL in the population. Raising awareness of the possible future impact of neck pain on physical HRQoL is important for health-care providers and policy makers with respect to the management of neck pain in populations.

摘要

背景信息

目前的证据表明，颈部疼痛与健康相关生活质量（HRQoL）呈负相关。然而，这些研究均为横断面研究，并未揭示颈部疼痛与未来HRQoL之间的关联。

目的

本研究旨在调查颈部疼痛严重程度增加与6个月后HRQoL之间的关联。此外，这项纵向研究还考察了颈部疼痛病程与HRQoL之间的粗略关联。

研究设计

这是一项基于人群的队列研究。

患者样本

纳入了1100名随机抽取的萨斯喀彻温省成年人。

结局指标

结局指标为简短健康调查问卷（SF-36）的心理成分总结（MCS）和身体成分总结（PCS）。

方法

1995年9月，我们组建了一个由1100名随机抽取的萨斯喀彻温省成年人组成的队列。我们使用慢性疼痛问卷来测量颈部疼痛及其相关残疾情况。6个月后，使用SF-36问卷来测量身体和心理HRQoL。在控制混杂因素的同时，采用多变量线性回归来测量分级颈部疼痛与HRQoL之间的关联。采用方差分析和t检验来测量6个月时颈部疼痛的四种可能病程与HRQoL之间的粗略关联。颈部疼痛在6个月内的轨迹为无或轻度颈部疼痛、颈部疼痛改善、颈部疼痛恶化和持续性颈部疼痛。最后，采用方差分析来检验四个颈部疼痛轨迹组从基线到6个月时PCS和MCS评分的变化。

结果

6个月的随访率为74.9%。在调整年龄、教育程度、关节炎、腰痛和抑郁症状后，我们发现颈部疼痛与身体HRQoL之间存在暴露-反应关系。与基线时无颈部疼痛的参与者相比，轻度（β=-1.53，95%置信区间[CI]=-2.83，-0.24）、重度（β=-3. – 60，95% CI=-5.76，-1.44）或致残性（β=-8.55，95% CI=-11.68，-5.42）颈部疼痛的参与者在6个月后身体HRQoL较差。我们未发现颈部疼痛与心理HRQoL之间存在关联。颈部疼痛恶化病程和持续性颈部疼痛与较差身体HRQoL相关。

结论

我们发现颈部疼痛与身体HRQoL呈负相关，但与心理HRQoL无关。我们的分析表明，颈部疼痛可能是该人群未来身体HRQoL不佳的一个因素。对于医疗保健提供者和政策制定者而言，提高对颈部疼痛可能对未来身体HRQoL产生的影响的认识，对于人群颈部疼痛的管理非常重要。