报告中度至重度疼痛的严重精神疾病老年患者的社会人口学特征、健康状况和功能损害
Sociodemographic characteristics, health conditions, and functional impairment among older adults with serious mental illness reporting moderate-to-severe pain.
作者信息
Brooks Jessica M, Umucu Emre, Huck Garrett E, Fortuna Karen, Sánchez Jennifer, Chiu Chungyi, Bartels Stephen J
机构信息
Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College.
Department of Rehabilitation Sciences, University of Texas at El Paso.
出版信息
Psychiatr Rehabil J. 2018 Sep;41(3):224-233. doi: 10.1037/prj0000316.
OBJECTIVE
To compare adults aged ≥50 years with serious mental illness reporting moderate-to-severe pain to older adults with serious mental illness without pain with respect to sociodemographic characteristics, health conditions, and functional impairment.
METHOD
Secondary data analyses were conducted using baseline assessments of 183 participants recruited for the Helping Older People Experience Success (HOPES) study from three community mental health centers. The primary outcome was self-reported, nonexperimentally induced, moderate-to-severe pain (referent = no-to-mild pain). Predictor variables consisted of sociodemographic characteristics, health conditions, and functional impairment. We conducted univariable and multivariable logistic regression analyses to examine the associations between these variables.
RESULTS
Sixty-one participants (33.3%) from our sample reported pain. Pain was associated with all of the sociodemographic and health-related factors in univariable analyses. In the multivariable model, only older age, pain-related activity interference, and physical and emotional health-related social limitations were significantly associated with pain.
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
The presence of moderate-to-severe pain in older adults with serious mental illness is associated with pain-attributable impairment of activities and social problems above and beyond the substantial functional limitations routinely experienced by this high-risk, high-need group. Given the high rates of preexisting conditions and persistent social impairment among these older adults, our findings suggest that pain may contribute to worse overall functional outcomes. Future research and clinical interventions focused on improving outcomes should include an evaluation of pain as a contributor to decreased functioning and assess the need for early intervention, nonpharmacological pain management, or other health promotion services in psychiatric rehabilitation. (PsycINFO Database Record
目的
比较年龄≥50岁且患有严重精神疾病并报告有中度至重度疼痛的成年人与患有严重精神疾病但无疼痛的老年人在社会人口学特征、健康状况和功能损害方面的差异。
方法
使用从三个社区心理健康中心招募的183名参与“帮助老年人体验成功”（HOPES）研究的参与者的基线评估数据进行二次数据分析。主要结局是自我报告的、非实验诱发的中度至重度疼痛（参照组 = 无至轻度疼痛）。预测变量包括社会人口学特征、健康状况和功能损害。我们进行了单变量和多变量逻辑回归分析，以检验这些变量之间的关联。
结果
我们样本中的61名参与者（33.3%）报告有疼痛。在单变量分析中，疼痛与所有社会人口学和健康相关因素相关。在多变量模型中，只有年龄较大、与疼痛相关的活动干扰以及与身体和情绪健康相关的社会限制与疼痛显著相关。
结论及对实践的启示
患有严重精神疾病的老年人出现中度至重度疼痛与因疼痛导致的活动损害以及社会问题相关，这些问题超出了这个高风险、高需求群体通常所经历的严重功能限制。鉴于这些老年人中既有疾病发生率高且持续存在社会损害，我们的研究结果表明疼痛可能导致更差的总体功能结局。未来旨在改善结局的研究和临床干预应包括评估疼痛对功能下降的影响，并评估在精神康复中进行早期干预、非药物疼痛管理或其他健康促进服务的必要性。（PsycINFO数据库记录）
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