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美国无证拉丁裔移民中的慢性疼痛和心理困扰。

Chronic Pain and Psychological Distress Among Undocumented Latinx Immigrants in the USA.

机构信息

Center for Research to Advance Community Health (ReACH) and Department of Medicine, Long School of Medicine, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, TX, USA.

Psychological Sciences, Rice University, Houston, TX, USA.

出版信息

J Gen Intern Med. 2021 Mar;36(3):585-591. doi: 10.1007/s11606-020-05910-2. Epub 2021 Jan 11.

Abstract

BACKGROUND

Undocumented immigration is often accompanied by multiple and complex stressors, which over time may increase the risk for chronic pain.

OBJECTIVE

This study aimed to identify the prevalence of chronic pain and its association with psychological distress among undocumented Latinx immigrants in the USA.

DESIGN/PARTICIPANTS: We used respondent-driven sampling to collect and analyze data from clinical interviews with 254 undocumented Latinx immigrants, enabling inference to a population of 22,000.

MAIN MEASURES

Chronic pain was assessed using the World Health Organization Composite International Diagnostic Interview (CIDI) Chronic Conditions Module. For all analyses, inferential statistics accounted for design effects and sample weights to produce weighted estimates. We conducted logistic regression analyses to assess the association between chronic pain and psychological distress after controlling for age, years in the USA, and history of trauma.

RESULTS

A total of 28% of undocumented Latinx immigrants reported having chronic pain, and 20% of those had clinically significant psychological distress. Significant differences in the prevalence of chronic pain were reported across age groups, years in the USA, and trauma history. After controlling for relevant covariates, chronic pain was significantly associated with psychological distress (OR = 1.06, 95% CI [1.02, 1.09]), age (OR = 1.05, 95% CI [1.02; 1.09]), and history of trauma (OR = 1.10 per additional traumatic event, 95% CI [1.02; 1.19]; C-statistic = 0.79).

CONCLUSION

Among undocumented Latinx immigrants, chronic pain is significantly associated with psychological distress, older age, and trauma history. Given that undocumented immigrants have restricted access to healthcare and are at high risk for chronic pain, developing alternatives to facilitate access to chronic pain interventions and risk-reduction prevention are needed.

摘要

背景

无证移民通常伴随着多种复杂的压力源,这些压力源随着时间的推移可能会增加患慢性疼痛的风险。

目的

本研究旨在确定美国无证拉丁裔移民中慢性疼痛的流行程度及其与心理困扰的关系。

设计/参与者:我们使用受访者驱动抽样法,对 254 名无证拉丁裔移民进行了临床访谈,收集和分析数据,从而推断出 22000 人的人群数据。

主要措施

使用世界卫生组织综合国际诊断访谈(CIDI)慢性疾病模块评估慢性疼痛。对于所有分析,推理统计数据考虑了设计效果和样本权重,以产生加权估计。在控制年龄、在美国的年限和创伤史后,我们进行了逻辑回归分析,以评估慢性疼痛与心理困扰之间的关联。

结果

共有 28%的无证拉丁裔移民报告患有慢性疼痛,其中 20%的人有明显的心理困扰。在年龄组、在美国的年限和创伤史方面,慢性疼痛的患病率存在显著差异。在控制相关协变量后,慢性疼痛与心理困扰显著相关(OR=1.06,95%CI[1.02,1.09]),年龄(OR=1.05,95%CI[1.02;1.09])和创伤史(每增加一次创伤性事件,OR=1.10,95%CI[1.02;1.19];C 统计量=0.79)。

结论

在无证拉丁裔移民中,慢性疼痛与心理困扰、年龄较大和创伤史显著相关。鉴于无证移民获得医疗保健的机会有限,且患慢性疼痛的风险较高,需要开发替代方法,以促进获得慢性疼痛干预和降低风险的预防措施。

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