Mehok Lauren E, Miller Megan M, Trost Zina, Goubert Liesbet, De Ruddere Lies, Hirsh Adam T
Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, USA.
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Pain Res. 2019 Sep 19;12:2743-2753. doi: 10.2147/JPR.S218761. eCollection 2019.
Despite the notable benefits of physical activity for chronic pain, a large proportion of patients with chronic pain report that they do not receive activity-related recommendations from their providers. Research suggests that patient factors such as weight and gender influence activity-related recommendations for chronic pain. Research also suggests that appraisals of the intensity and cause of pain may explain these weight and gender effects. We investigated the influence of patient weight and gender on observers' likelihood of recommending activity-related treatments for pain. We also explored the mediating effects of observers' ratings of pain severity and the extent to which pain was due to medical and lifestyle factors (pain attribution).
Healthy young adults (N=616; 76% female) viewed videos (Ghent Pain Videos of Daily Activities) and vignettes of 4 patients with chronic back pain performing a standardized functional task. Patients varied by gender (female, male) and weight (normal, obese), but were otherwise equivalent on demographic characteristics and pain behaviors. Participants rated how much pain they perceived the patients to be experiencing, the extent to which they attributed the pain to medical and lifestyle factors, and their likelihood of recommending exercise, physical therapy (PT), and rest.
Patient weight and gender significantly interacted to influence exercise, PT, and rest recommendations. Both pain intensity and pain attribution mediated the relationships between patient weight and activity recommendations; however, these mediation effects differed across gender and recommendation type.
Patient weight and gender influenced laypeople's activity recommendations for chronic pain. Moreover, the results suggest that observers' perceptions of pain intensity and pain attributions are mechanisms underlying these effects. If these findings are replicated in providers, interventions may need to be developed to reduce provider biases and increase their recognition of the benefits of physical activity for chronic pain.
尽管体育活动对慢性疼痛有显著益处，但很大一部分慢性疼痛患者表示，他们没有从医疗服务提供者那里得到与活动相关的建议。研究表明，体重和性别等患者因素会影响慢性疼痛患者的活动相关建议。研究还表明，对疼痛强度和原因的评估可能解释了这些体重和性别效应。我们调查了患者体重和性别对观察者推荐与活动相关的疼痛治疗的可能性的影响。我们还探讨了观察者对疼痛严重程度的评分以及疼痛在多大程度上归因于医疗和生活方式因素（疼痛归因）的中介作用。
健康的年轻成年人（N = 616；76%为女性）观看了视频（根特日常活动疼痛视频）以及4名慢性背痛患者执行标准化功能任务的小片段。患者的性别（女性、男性）和体重（正常、肥胖）各不相同，但在人口统计学特征和疼痛行为方面其他方面相当。参与者对他们认为患者所经历的疼痛程度、他们将疼痛归因于医疗和生活方式因素的程度以及他们推荐运动、物理治疗（PT）和休息的可能性进行了评分。
患者体重和性别显著相互作用，影响运动、PT和休息的建议。疼痛强度和疼痛归因都介导了患者体重与活动建议之间的关系；然而，这些中介效应在性别和建议类型之间存在差异。
患者体重和性别影响了外行人对慢性疼痛的活动建议。此外，结果表明观察者对疼痛强度和疼痛归因的认知是这些效应的潜在机制。如果这些发现在医疗服务提供者中得到重复，可能需要制定干预措施以减少医疗服务提供者的偏见，并提高他们对体育活动对慢性疼痛益处的认识。
