Docking Rachael E, Beasley Marcus, Steinerowski Artur, Jones Elizabeth A, Farmer Jane, Macfarlane Gary J, Jones Gareth T
Musculoskeletal Research Collaboration (Epidemiology Group), University of Aberdeen, Aberdeen, UK ; Faculty of Education and Health, University of Greenwich,London, UK.
Musculoskeletal Research Collaboration (Epidemiology Group), University of Aberdeen, Aberdeen, UK.
Br J Pain. 2015 May;9(2):86-95. doi: 10.1177/2049463714527438.
To examine whether the prevalence of regional and chronic widespread pain (CWP) varies with rurality and to determine the characteristics of persons in rural locations in whom pain is found to be in excess.
Participants, aged ≥55 years, from participating general practices in seven different geographical locations in Scotland were sent a postal questionnaire. The 1-month prevalence of 10 regional pain conditions plus CWP was identified using body manikins. Differences in the prevalence of pain with differing rurality were examined using Chi(2) test for trend. Thereafter, among the rural population, the relationships between pain and putative risk factors were examined using Poisson regression. Thus, results are described as risk ratios.
There was some evidence to suggest that the prevalence of CWP increased with increasing rurality, although the magnitude of this was slight. No large or significant differences were observed with any regional pain conditions. Factors associated with the reporting of CWP included poor general health, feeling downhearted most of the time and selected measures of social contact. Factors independently associated with CWP included female gender (risk ratio: 1.24; 95% confidence interval (CI): 0.997-1.55), poor self-rated health (risk ratio: 3.50; 95% CI: 1.92-6.39) and low mood (risk ratio: 1.54; 95% CI: 1.07-2.20). Also, having fewer than 10 people to turn to in a crisis was associated with a decrease in the risk of CWP - risk ratio: 0.68 (95% CI: 0.50-0.93) and 0.78 (95% CI: 0.60-1.02) for those with 5-10 and <5 people, respectively.
This study provides no evidence that the prevalence of regional musculoskeletal pain is increased in rural settings, although there is some evidence of a modest increase in CWP. Risk factors for CWP are similar to those seen in the urban setting, including markers of general health, mental health and also aspects of social contact. It may be, however, that social networks are more difficult to maintain in rural settings, and clinicians should be aware of the negative effect of perceived social isolation on pain in rural areas.
研究局部疼痛和慢性广泛性疼痛（CWP）的患病率是否随农村地区情况而变化，并确定农村地区疼痛发生率过高人群的特征。
向来自苏格兰七个不同地理位置参与研究的普通诊所中年龄≥55岁的参与者发送邮政调查问卷。使用人体模型确定10种局部疼痛状况加CWP的1个月患病率。使用趋势卡方检验研究不同农村地区疼痛患病率的差异。此后，在农村人口中，使用泊松回归研究疼痛与假定风险因素之间的关系。因此，结果以风险比描述。
有一些证据表明CWP的患病率随农村地区程度的增加而上升，尽管幅度较小。在任何局部疼痛状况方面均未观察到显著差异。与CWP报告相关的因素包括总体健康状况差、大部分时间情绪低落以及社交接触的某些指标。与CWP独立相关的因素包括女性（风险比：1.24；95%置信区间（CI）：0.997 - 1.55）、自评健康状况差（风险比：3.50；95%CI：1.92 - 6.39）和情绪低落（风险比：1.54；95%CI：1.07 - 2.20）。此外，在危机中可求助的人数少于10人会使CWP风险降低——对于有5 - 10人和少于5人的人群，风险比分别为0.68（95%CI：0.50 - 0.93）和0.78（95%CI：0.60 - 1.02）。
本研究没有证据表明农村地区局部肌肉骨骼疼痛的患病率增加，尽管有一些证据表明CWP略有增加。CWP的风险因素与城市环境中所见的相似，包括总体健康、心理健康指标以及社交接触方面。然而，在农村地区可能更难维持社交网络，临床医生应意识到感知到的社会隔离对农村地区疼痛的负面影响。
