Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, NSW, Australia.
Rheumatology (Oxford). 2021 Mar 2;60(3):1291-1299. doi: 10.1093/rheumatology/keaa494.
To evaluate the association between psychological factors and pain exacerbations in people with hip OA.
Eligible participants with symptomatic hip OA were instructed to complete online questionnaires every 10 days over a 90-day follow-up period. In addition, they were required to complete the questionnaire whenever they perceived they were experiencing a hip pain exacerbation. Hip pain exacerbation was defined as an increase of 2 points in pain intensity compared with baseline on an 11-point numeric rating scale (0-10). The Depression, Anxiety and Stress Scale-21 Items, Positive and Negative Affect Schedule, Pain Catastrophizing Scale and Pain Self-Efficacy Questionnaire were used to evaluate psychological factors. The associations of these with risk of hip pain exacerbation were examined by conditional logistic regression.
Of 252 participants recruited, 131 (52.0%) contributed both case and control period data and were included in the analysis. A significant association was found between Pain Catastrophizing Scale overall score (1 point increase) with hip pain exacerbations (odds ratio: 1.07, 95% CI: 1.04, 1.11). An increase of a minimal important change (5.5 points) of Pain Self-Efficacy Questionnaire score was associated with a lower odds of pain exacerbations (odds ratio: 0.74, 95% CI: 0.65, 0.85). No significant associations were found between Depression, Anxiety and Stress Scale-21 Items or Positive and Negative Affect Schedule scores with hip pain exacerbations.
Both pain catastrophizing and pain self-efficacy beliefs were associated with pain exacerbations in people with hip OA, but other psychological factors including depression, anxiety and stress or positive and negative affects, were not associated with pain exacerbations.
评估心理因素与髋骨关节炎患者疼痛加重之间的关系。
符合条件的有症状髋骨关节炎患者被指示在 90 天的随访期间，每 10 天在线完成一次问卷调查。此外，当他们感觉到髋部疼痛加重时，他们需要完成问卷。髋部疼痛加重被定义为在 11 点数字评分量表（0-10）上与基线相比疼痛强度增加 2 分。使用抑郁、焦虑和压力量表 21 项、正负情感量表、疼痛灾难化量表和疼痛自我效能问卷来评估心理因素。通过条件逻辑回归检查这些因素与髋部疼痛加重风险的关联。
在招募的 252 名参与者中，有 131 名（52.0%）同时提供了病例和对照期的数据，并纳入了分析。疼痛灾难化量表总分（增加 1 分）与髋部疼痛加重之间存在显著关联（优势比：1.07，95%可信区间：1.04，1.11）。疼痛自我效能问卷评分增加微小临床重要差异（5.5 分）与疼痛加重的可能性降低相关（优势比：0.74，95%可信区间：0.65，0.85）。抑郁、焦虑和压力量表 21 项或正负情感量表评分与髋部疼痛加重之间没有显著关联。
疼痛灾难化和疼痛自我效能信念均与髋骨关节炎患者的疼痛加重有关，但其他心理因素，包括抑郁、焦虑和压力或正负情感，与疼痛加重无关。
