University of Florida, Department of Aging and Geriatric Research, Gainesville, Florida.
University of Florida, College of Nursing, Gainesville, Florida.
J Pain. 2021 Nov;22(11):1452-1466. doi: 10.1016/j.jpain.2021.04.018. Epub 2021 May 24.
The current cross-sectional study investigates whether pain catastrophizing mediates the relationship between ethnicity/race and pain, disability and physical function in individuals with knee osteoarthritis. Furthermore, this study examined mediation at 2-year follow-up. Participants included 187 community-dwelling adults with unilateral or bilateral knee pain who screened positive for knee osteoarthritis. Participants completed several self-reported pain-related measures and pain catastrophizing subscale at baseline and 2-year follow-up. Non-Hispanic Black (NHB) adults reported greater pain, disability, and poorer functional performance compared to their non-Hispanic White (NHW) counterparts (Ps < .05). NHB adults also reported greater catastrophizing compared to NHW adults. Mediation analyses revealed that catastrophizing mediated the relationship between ethnicity/race and pain outcome measures. Specifically, NHB individuals reported significantly greater pain and disability, and exhibited lower levels of physical function, compared to NHW individuals, and these differences were mediated by higher levels of catastrophizing among NHB persons. Catastrophizing was a significant predictor of pain and disability 2-years later in both ethnic/race groups. These results suggest that pain catastrophizing is an important variable to consider in efforts to reduce ethnic/race group disparities in chronic pain. The findings are discussed in light of structural/systemic factors that may contribute to greater self-reports of pain catastrophizing among NHB individuals. PERSPECTIVE: The current study examines whether pain catastrophizing mediates the relationship between ethnicity/race and OA-related pain, disability, and functional impairment at baseline and during a 2-year follow-up period in non-Hispanic Black and non-Hispanic White adults with knee pain. These results point to the need for interventions that target pain catastrophizing.
本横断面研究旨在探讨疼痛灾难化是否在非裔美国人和非裔白人膝骨关节炎患者的种族/民族与疼痛、残疾和身体功能之间的关系中起中介作用。此外，本研究还检验了 2 年随访时的中介作用。参与者包括 187 名居住在社区的单侧或双侧膝关节疼痛的成年人，这些成年人经筛选患有膝骨关节炎。参与者在基线和 2 年随访时完成了几项自我报告的与疼痛相关的测量和疼痛灾难化子量表。与非西班牙裔白人（NHW）相比，非西班牙裔黑人（NHB）成年人报告的疼痛、残疾和功能表现更差（P <.05）。与 NHW 成年人相比，NHB 成年人报告的灾难化程度更高。中介分析显示，灾难化在种族/民族与疼痛结果测量之间的关系中起中介作用。具体来说，与 NHW 个体相比，NHB 个体报告的疼痛和残疾更严重，身体功能水平更低，而 NHB 个体的这些差异是由更高水平的灾难化引起的。在两个种族群体中，灾难化是 2 年后疼痛和残疾的重要预测因素。这些结果表明，在努力减少慢性疼痛中种族/民族差异时，疼痛灾难化是一个需要考虑的重要变量。这些发现是根据可能导致 NHB 个体报告更多疼痛灾难化的结构性/系统性因素进行讨论的。观点：本研究在非西班牙裔黑人和非西班牙裔白人士兵膝痛患者中，检查了疼痛灾难化是否在基线和 2 年随访期间，在种族/民族与 OA 相关疼痛、残疾和功能障碍之间的关系中起中介作用。这些结果表明需要针对疼痛灾难化进行干预。
