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一项基于冰岛人口的疼痛患病率研究。

A population based study of the prevalence of pain in Iceland.

作者信息

Gunnarsdottir Sigridur, Ward Sandra E, Serlin Ronald C

机构信息

Landsptali National University Hospital of Iceland, Faculty of Nursing, Eiriksgata 34, 101 Reykjavik, Iceland.

National Hospital, Reykjavik, Iceland.

出版信息

Scand J Pain. 2010 Jul 1;1(3):151-157. doi: 10.1016/j.sjpain.2010.05.028.

DOI:10.1016/j.sjpain.2010.05.028
PMID:29913984
Abstract

Prevalence estimates of pain differ depending on how it is defined and measured and on the populations studied. It has been estimated that on a given day, as many as 30-44% of the general population experience some kind of pain. Information about the prevalence of pain in Iceland is not available. The aims of this study were to evaluate the prevalence of pain of various origins among the general population of Iceland, to test hypotheses regarding relationships between pain, quality of life (QOL) and demographic variables, to evaluate participants' beliefs about causes of their pain, and to evaluate how those who experience pain manage it. A random sample of 1286 adults was drawn from a national registry holding information about all citizens of Iceland. Data were collected with a postal-survey. Pain was evaluated with the Brief Pain Inventory (BPI), with instructions modified to evaluate pain in the past week as opposed to the past 24 h. Of 1286 invited, 599 (46.6%) participated, of which, 232 had experienced pain in the past week (40.3%). Participants had a mean (SD) age of 44.94 (17.12) years and 56% were women. Those who had pain perceived their health to be worse than those who had not [B = -0.91, SE = 0.15, Wald = 38.75, p = 0.00], but did not differ on other variables. Of 232 individuals reporting pain, 183 (79.6%) or 30.6% of the total sample had experienced pain for more than three months. On a scale from 0 "no pain" to 10 "pain as bad as I can imagine" the mean (SD) pain severity score (composite of four pain severity scores) for the 232 participants reporting pain was 3.21 (1.73) and pain interference with life activities 2.59 (1.98), also on a 0-10 scale. Pain severity predicted pain interference [B = 0.71; F = 126.14; df = 1,206; p = 0.00], which mediated the effects of pain severity on mood and QOL. Between Pain Interference with Life and Positive Affect [B = -0.06; F = 4.53; df = 1,196; p = 0.04], between Pain Interference and Negative Affect [B = 0.15; F = 23.21; df = 1,196; p = 0.00], and between Pain Interference and Global Quality of Life [B = -0.18; F = 29.11; df = 1,196; p = 0.00]. Most frequent causes for pain were strain injuries (n = 79), resulting from work or sports activity, arthritis (n = 39), mechanical problems (e.g. due to birth defects, curvature, slipped discs, etc.) (n = 37), various diseases (n = 31) and accidents (n = 30). Nineteen participants did not know what caused their pain. Treatments for pain varied, but most had used medications alone (n = 76) or in combination with other treatments (n = 61). The prevalence of pain in the general population of Icelandic adults is similar to what has been reported. Estimates of chronic pain are towards the higher end when compared to data from other European counties, yet comparable to countries such as Norway. This raises questions about possible explanations to be looked for in genetics or cultural point of view. This population based study provides valuable information about the prevalence of pain in Iceland and also supports findings previously reported about pain in the neighboring countries.

摘要

疼痛患病率的估计值因疼痛的定义和测量方式以及所研究的人群而异。据估计,在某一特定日子,多达30%-44%的普通人群会经历某种疼痛。目前尚无冰岛疼痛患病率的相关信息。本研究的目的是评估冰岛普通人群中各种来源疼痛的患病率,检验关于疼痛、生活质量(QOL)和人口统计学变量之间关系的假设,评估参与者对其疼痛原因的看法,并评估经历疼痛的人如何应对疼痛。从一个保存着冰岛所有公民信息的国家登记处抽取了1286名成年人的随机样本。通过邮寄调查收集数据。使用简明疼痛量表(BPI)评估疼痛,其指导语经过修改以评估过去一周而非过去24小时内的疼痛情况。在1286名受邀者中,599人(46.6%)参与了调查,其中232人在过去一周内经历过疼痛(40.3%)。参与者的平均(标准差)年龄为44.94(17.12)岁,56%为女性。经历疼痛的人认为自己的健康状况比未经历疼痛的人更差[B = -0.91,标准误 = 0.15,Wald = 38.7,5,p = 0.00],但在其他变量上没有差异。在232名报告疼痛的个体中,183人(79.6%)或占总样本的30.6%经历疼痛超过三个月。在从0(“无疼痛”)到10(“我能想象到的最剧烈的疼痛”)的量表上,232名报告疼痛的参与者的平均(标准差)疼痛严重程度得分(四个疼痛严重程度得分的综合)为3.21(1.73),疼痛对生活活动的干扰程度为2.59(1.98),同样采用0-10分制。疼痛严重程度可预测疼痛干扰程度[B = 0.71;F = 126.14;自由度 = 1,206;p = 0.00],疼痛干扰程度介导了疼痛严重程度对情绪和生活质量的影响。在疼痛对生活的干扰与积极情绪之间[B = -0.06;F = 4.53;自由度 = 1,196;p = 0.04],在疼痛干扰与消极情绪之间[B = 0.15;F = 23.21;自由度 = 1,196;p = 0.00],以及在疼痛干扰与总体生活质量之间[B = -0.18;F = 29.11;自由度 = 1,196;p = 0.00]。最常见的疼痛原因是劳损性损伤(n = 79),由工作或体育活动引起,关节炎(n = 39),机械问题(如由于出生缺陷、脊柱弯曲、椎间盘突出等)(n = 37),各种疾病(n = 31)和事故(n = 30)。19名参与者不知道疼痛的原因。疼痛的治疗方法各不相同,但大多数人单独使用药物(n = 76)或与其他治疗方法联合使用(n = 61)。冰岛成年普通人群中疼痛的患病率与已报道的情况相似。与其他欧洲国家的数据相比,慢性疼痛的估计值偏高,但与挪威等国家相当。这引发了从遗传学或文化角度寻找可能解释的问题。这项基于人群的研究提供了关于冰岛疼痛患病率的宝贵信息,也支持了之前关于邻国疼痛情况的报道。

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