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慢性广泛性疼痛患者接受多学科治疗与睡眠质量相关的因素。

Factors Associated With Sleep Quality in Patients With Chronic Widespread Pain Attending Multidisciplinary Treatment.

机构信息

Amsterdam Rehabilitation Research Center|Reade, Amsterdam, The Netherlands.

Department of Rehabilitation Medicine, Amsterdam UMC, Amsterdam, The Netherlands.

出版信息

Pain Pract. 2020 Jun;20(5):471-479. doi: 10.1111/papr.12873. Epub 2020 Feb 28.

Abstract

PURPOSE

(1) To investigate the prevalence of poor sleep quality and (2) to explore the associations between clinical, cognitive, and emotional factors and quality of sleep in patients with chronic widespread pain (CWP) receiving multidisciplinary treatment.

METHOD

Baseline data were used from 163 patients with CWP referred for multidisciplinary treatment. Linear regression models were used to assess the relationship of clinical (pain, fatigue, pain interference, and disability), emotional (anxiety, depression, and psychological distress), and cognitive factors (catastrophizing, acceptance, self-efficacy, kinesiophobia and illness beliefs) with sleep quality, as measured using the Pittsburgh Sleep Quality Index.

RESULTS

Poor sleep quality was found in 92% of the patients. The multivariable model showed that a higher level of fatigue (b = 1.77, standard error [SE] = 0.62, β = 0.21, t = 2.87, P < 0.01), psychological distress (b = 0.02, SE = 0.01, β = 0.27, t = 3.50, P < 0.01), and more concerns about the illness (b = 0.46, SE = 0.18, β = 0.20, t = 2.57, P = 0.01) were independently associated with poorer quality of sleep. The overall linear regression model explains 27.9% of sleep quality.

CONCLUSIONS

The high prevalence of poor sleep quality in patients with CWP referred for multidisciplinary treatment emphasizes the need to target sleep during treatment. Further research is needed to disentangle the cause-effect relationship between fatigue, psychological distress, and concerns about the illness and poor sleep (note: this abstract has been published before [Ann Rheum Dis. 2018;77:A1788]).

摘要

目的

(1)调查接受多学科治疗的慢性广泛性疼痛(CWP)患者睡眠质量差的患病率,(2)探讨临床、认知和情绪因素与睡眠质量的关系。

方法

使用 163 名 CWP 患者的基线数据,这些患者接受了多学科治疗。线性回归模型用于评估临床(疼痛、疲劳、疼痛干扰和残疾)、情绪(焦虑、抑郁和心理困扰)和认知因素(灾难化、接受、自我效能、运动恐惧和疾病信念)与睡眠质量的关系,睡眠质量使用匹兹堡睡眠质量指数进行测量。

结果

92%的患者睡眠质量差。多变量模型显示,更高水平的疲劳(b=1.77,标准误差[SE]=0.62,β=0.21,t=2.87,P<0.01)、心理困扰(b=0.02,SE=0.01,β=0.27,t=3.50,P<0.01)和对疾病的更多关注(b=0.46,SE=0.18,β=0.20,t=2.57,P=0.01)与睡眠质量较差独立相关。总体线性回归模型解释了睡眠质量的 27.9%。

结论

多学科治疗的 CWP 患者睡眠质量差的高患病率强调了在治疗过程中需要针对睡眠进行治疗。需要进一步研究以阐明疲劳、心理困扰和对疾病的担忧与睡眠质量差之间的因果关系(注:该摘要以前已发表[Ann Rheum Dis. 2018;77:A1788])。

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