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社会人口学因素和心理社会因素如何与14个不同身体部位的严重疼痛患病率及慢性疼痛相关?一项基于人群的横断面调查。

How are socio-demographic and psycho-social factors associated with the prevalence and chronicity of severe pain in 14 different body sites? A cross-sectional population-based survey.

作者信息

Dorner Thomas Ernst, Stein Katharina Viktoria, Hahne Julia, Wepner Florian, Friedrich Martin, Mittendorfer-Rutz Ellenor

机构信息

Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090, Vienna, Austria.

International Foundation for Integrated Care, The Quorum, Oxford Business Park North, Garsington Road, 7200, Oxford, UK.

出版信息

Wien Klin Wochenschr. 2018 Jan;130(1-2):14-22. doi: 10.1007/s00508-017-1223-x. Epub 2017 Jun 20.

Abstract

BACKGROUND

Severe pain and chronic pain have a high impact on individuals and society. Body location of pain is important with regard to perception, articulation, and underlying biological, mental or social causes of pain.

METHODS

A cross-sectional survey was performed in the general Austrian population with 15,474 personally interviewed subjects aged 15 years and older.

RESULTS

The 1‑year period prevalence of severe pain in any body site was 38.6% and of chronic pain 24.9%. In all, 8.1% had pain in at least three body sites. Subjects aged 65 years and older (52.2%), those with low education (43.4%), unemployed subjects (50.4%), retired subjects (52.4%), those with anxiety/depression (67.7%), and subjects with lack of social support (49.6%) were sub-populations with high pain prevalence. In multivariate analyses, depression/anxiety was associated with prevalence and chronicity of severe pain in all body sites (range of ORs 1.89-5.01), while such associations were found for lack of social support (range of ORs 1.33-1.65), female sex (range of ORs 1.38-2.34), higher age (range of ORs 1.09-1.18 for 5 year intervals), as well as low educational (range of ORs 1.47-2.06 primary vs. tertiary education) and unemployment status (range of ORs 1.50-2.62) in most body sites. Being born in non-EU or EFTA states was associated with pain in many body sites (range of ORs 1.38-2.10).

CONCLUSIONS

Psychosocial factors are associated with pain presence in similar ways irrespective of location. Regarding socio-demographic factors, differences towards the magnitude and the direction in the association with pain frequency and chronicity in different body sites emerged.

摘要

背景

重度疼痛和慢性疼痛对个人和社会都有很大影响。疼痛的身体部位对于疼痛的感知、表述以及潜在的生物学、心理或社会原因而言都很重要。

方法

对奥地利普通人群进行了一项横断面调查,共对15474名年龄在15岁及以上的受试者进行了个人访谈。

结果

任何身体部位的重度疼痛1年期间患病率为38.6%,慢性疼痛为24.9%。共有8.1%的人至少在三个身体部位有疼痛。65岁及以上的受试者(52.2%)、低学历者(43.4%)、失业者(50.4%)、退休者(52.4%)、有焦虑/抑郁者(67.7%)以及缺乏社会支持者(49.6%)是疼痛患病率较高的亚人群。在多变量分析中,抑郁/焦虑与所有身体部位重度疼痛的患病率和慢性疼痛相关(比值比范围为1.89 - 5.01),而缺乏社会支持(比值比范围为1.33 - 1.65)、女性(比值比范围为1.38 - 2.34)、较高年龄(每5年间隔的比值比范围为1.09 - 1.18)以及大多数身体部位的低学历(小学与高等教育相比的比值比范围为1.47 - 2.06)和失业状况(比值比范围为1.50 - 2.62)也存在此类关联。出生在非欧盟或欧洲自由贸易联盟国家与许多身体部位的疼痛相关(比值比范围为1.38 - 2.10)。

结论

无论疼痛部位如何,心理社会因素与疼痛存在的关联方式相似。关于社会人口学因素,在不同身体部位与疼痛频率和慢性疼痛的关联程度和方向上出现了差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42a/5772122/bf884a001890/508_2017_1223_Fig1_HTML.jpg

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