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社会隔离在慢性疼痛患者身体和情绪结果中的作用。

The role of social isolation in physical and emotional outcomes among patients with chronic pain.

机构信息

Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.

Harvard Medical School, Boston, MA, USA; Department of Biostatistics, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.

出版信息

Gen Hosp Psychiatry. 2021 Mar-Apr;69:50-54. doi: 10.1016/j.genhosppsych.2021.01.009. Epub 2021 Jan 28.

Abstract

OBJECTIVE

Social isolation negatively impacts early-disease processes and long-term health. Individuals with chronic pain are more vulnerable to social isolation, which exacerbates symptoms. It is currently unclear whether: 1. group-based programs for chronic pain improve social isolation, 2. improvements in social isolation account for improvements in outcomes. This study involved secondary data analysis of participants in a 10-week mind-body physical activity program. We examined whether social isolation improved during treatment, and whether such improvements accounted for improvements in emotional and physical functioning.

METHODS

Participants (N = 82) with chronic pain were randomized to a group-based mind-body physical activity intervention with (GetActive-Fitbit; n = 41) or without a Fitbit device (GetActive; n = 41). Participants completed self-reported measures of social isolation, emotional functioning (depression and anxiety symptoms), and multimodal physical functioning (self-report, performance-based, and objective). We used linear mixed effects modeling to examine pre-post treatment changes in social isolation and whether these changes accounted for improvements in emotional and physical functioning.

RESULTS

Both interventions were associated with significant and comparable improvements in social isolation from baseline to end of treatment, and improvements in social isolation accounted for significant improvements in self-reported emotional and physical functioning.

CONCLUSION

Interventions may target social isolation in chronic pain to optimize treatment outcomes.

摘要

目的

社会隔离会对早期疾病进程和长期健康产生负面影响。患有慢性疼痛的人更容易受到社会隔离的影响,从而使症状恶化。目前尚不清楚:1. 针对慢性疼痛的团体计划是否能改善社会隔离,2. 社会隔离的改善是否能解释结局的改善。本研究对为期 10 周的心身身体活动项目的参与者进行了二次数据分析。我们检验了治疗过程中社会隔离是否得到改善,以及这种改善是否能解释情绪和身体功能的改善。

方法

随机将患有慢性疼痛的参与者(N=82)分为基于团体的心身身体活动干预组(使用 Fitbit 的 GetActive-Fitbit 组,n=41)和未使用 Fitbit 设备的 GetActive 组(n=41)。参与者完成了自我报告的社会隔离、情绪功能(抑郁和焦虑症状)和多模态身体功能(自我报告、基于表现和客观)的测量。我们使用线性混合效应模型来检验治疗前后社会隔离的变化,以及这些变化是否能解释情绪和身体功能的改善。

结果

两种干预措施都与社会隔离从基线到治疗结束的显著且可比的改善有关,社会隔离的改善与自我报告的情绪和身体功能的显著改善有关。

结论

干预措施可能以慢性疼痛中的社会隔离为靶点,以优化治疗结果。

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