Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
Unit for the Study and Treatment of Pain-ALGOS, Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.
Pain Pract. 2020 Jan;20(1):62-74. doi: 10.1111/papr.12827. Epub 2019 Aug 28.
To determine if there are sex differences in a sample of patients participating in a 4-week interdisciplinary pain treatment program in (1) pretreatment pain intensity, physical function, psychological function, pain beliefs, kinesiophobia, pain catastrophizing, and activity management patterns; and (2) treatment response.
Seventy-two men and 130 women with chronic pain completed study measures. Analyses of covariance (ANCOVAs) were performed to compare men and women on pretreatment measures. Repeated-measures ANCOVAs were used to compare both sexes on 3 treatment outcomes (pain intensity, physical function, and depressive symptoms).
Before treatment, compared to women, men reported higher levels of kinesiophobia, were more likely to view their pain as being harmful, and used more activity pacing when doing daily activities. Women were more likely to use an overdoing activity pattern than men. No sex differences emerged for pretreatment pain intensity, physical function, psychological function, catastrophizing, activity avoidance, or measures of other pain-related beliefs. At posttreatment, women reported more improvements in pain intensity and physical function compared to men, while both sexes reported similar reductions in depressive symptoms. All effect sizes for statistically significant findings were of small to moderate magnitude.
The results of this study suggest that men and women have a comparable profile with respect to the overall burden of chronic pain. Nevertheless, sex differences were found for certain pain beliefs and coping styles. Women appear to reap more benefits from the interdisciplinary pain management program than men. These findings indicate that further research to develop sex-specific assessment procedures and tailored pain treatments may be warranted.
在参与为期 4 周的跨学科疼痛治疗计划的患者样本中，确定（1）治疗前疼痛强度、身体功能、心理功能、疼痛信念、运动恐惧、疼痛灾难化和活动管理模式；以及（2）治疗反应是否存在性别差异。
72 名男性和 130 名女性慢性疼痛患者完成了研究措施。协方差分析（ANCOVA）用于比较男性和女性治疗前的指标。重复测量 ANCOVA 用于比较两性在 3 项治疗结果（疼痛强度、身体功能和抑郁症状）上的差异。
治疗前，与女性相比，男性报告的运动恐惧水平更高，更有可能认为自己的疼痛是有害的，并且在进行日常活动时更倾向于活动节奏。女性比男性更倾向于过度活动模式。在治疗前的疼痛强度、身体功能、心理功能、灾难化、活动回避或其他与疼痛相关的信念方面，没有出现性别差异。治疗后，与男性相比，女性报告的疼痛强度和身体功能改善更大，而两性的抑郁症状均有相似程度的减轻。所有具有统计学意义的发现的效应量均为小到中等幅度。
本研究的结果表明，男性和女性在慢性疼痛的总体负担方面具有相似的特征。然而，在某些疼痛信念和应对方式上存在性别差异。女性似乎从跨学科疼痛管理计划中获益更多。这些发现表明，可能需要进一步研究以开发针对特定性别的评估程序和量身定制的疼痛治疗方法。
