Müller Rachel, Landmann Gunther, Béchir Markus, Hinrichs Timo, Arnet Ursina, Jordan Xavier, Brinkhof Martin W G
Empowerment, Participation and Social Integration Unit, Swiss Paraplegic Research (SPF), 6207 Nottwil, Switzerland.
J Rehabil Med. 2017 Jun 28;49(6):489-496. doi: 10.2340/16501977-2241.
To test the hypotheses that: (i) pain is associated with depressive symptoms and quality of life; and (ii) participation restriction, satisfaction, and frequency mediate these relationships.
Population-based, cross-sectional study.
SUBJECTS/PATIENTS: Community-dwelling individuals with spinal cord injury (n = 1,549).
Hypotheses were tested in individuals with at least moderate chronic pain on the spinal cord injury - Secondary Conditions Scale (n = 834), applying structural equation modelling to data for spinal cord injury subgroups related to lesion severity (paraplegia, tetraplegia, complete, incomplete) and time since injury (≤ 10 vs ≥ 10 years). Model parameters included pain intensity (numerical rating scale), participation frequency, restriction, satisfaction (Utrecht Scale of Evaluation of Rehabilitation-Participation; USER-Participation), depressive symptoms (5-item Mental Health Index of the Short Form Health Survey; MHI-5), and 5 selected quality of life items (World Health Organization Quality of Life Scale; WHOQoL-BREF).
Structural equation models confirmed associations of pain with depressive symptoms and quality of life, as well as the mediating role of participation restriction and low satisfaction with participation. These findings were apparent in individuals with tetraplegia or complete lesion and in those ≤ 10 years since paraplegia or incomplete injury.
Unrestricted or satisfactory participation was found to be a crucial resource for individuals living less than 10 years with a more severe spinal cord injury, since it represents buffering potential for the negative effects of chronic pain on mental health and quality of life.
检验以下假设：（i）疼痛与抑郁症状及生活质量相关；（ii）参与限制、满意度和频率介导这些关系。
基于人群的横断面研究。
受试者/患者：社区居住的脊髓损伤个体（n = 1549）。
在脊髓损伤 - 继发性疾病量表上至少有中度慢性疼痛的个体（n = 834）中检验假设，将结构方程模型应用于与损伤严重程度（截瘫、四肢瘫、完全性、不完全性）和受伤时间（≤10年与≥10年）相关的脊髓损伤亚组数据。模型参数包括疼痛强度（数字评定量表）、参与频率、限制、满意度（乌得勒支康复参与评估量表；USER - 参与）、抑郁症状（简短健康调查问卷的5项心理健康指数；MHI - 5）以及5项选定的生活质量项目（世界卫生组织生活质量量表；WHOQoL - BREF）。
结构方程模型证实了疼痛与抑郁症状及生活质量之间的关联，以及参与限制和参与低满意度的中介作用。这些发现见于四肢瘫或完全性损伤的个体以及截瘫或不完全性损伤后≤10年的个体。
对于脊髓损伤较严重且受伤时间少于10年的个体，无限制或满意的参与是一项关键资源，因为它代表了缓冲慢性疼痛对心理健康和生活质量负面影响的潜力。
