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探讨联邦合格健康中心中拉丁裔成年人的疼痛体验和焦虑敏感性。

Exploring pain experience and anxiety sensitivity among Latinx adults in a federally qualified health center.

机构信息

Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA.

Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

J Behav Med. 2022 Jun;45(3):404-415. doi: 10.1007/s10865-022-00325-2. Epub 2022 May 14.

Abstract

The Latinx population is the largest minority group in the United States (U.S.) and is expected to continue to grow through at least 2050. Although there is growing recognition of the importance of pain among Latinx individuals, few studies have examined individualized psychological processes governing pain severity and disability in Latinx populations. One psychological factor that has shown promise in relation to pain experience specifically and clinical conditions more generally is anxiety sensitivity. The present investigation sought to (1) characterize the severity of pain among an unselected sample of adult Latinx individuals attending a Federally Qualified Health Center (FQHC); (2) evaluate the severity of anxiety sensitivity as a function of pain severity; and (3) test the potential explanatory relevance of anxiety sensitivity as an individual difference factor for pain intensity, pain disability, psychological inflexibility for emotional distress, and global life impairment. Participants included 406 adult Spanish-speaking Latinx persons (87.2% female; M = 40.26 years, SD = 11.20, and 98.3% used Spanish as their first language) who attended an FQHC in Houston, Texas. Analyses revealed that 62.6% of the sample had at least some pain, and 21.9% of the same had high intensity, moderate interference, or severe interference chronic pain. Further, results provided evidence for anxiety sensitivity as a function of pain grade, such that individuals with grade 2 (high-intensity pain), grade 3 (moderate pain interference), and grade 4 (severe pain interference) chronic pain reported significantly higher levels of anxiety sensitivity than those with grade 0 pain (no chronic pain). Additionally, after controlling for age, gender, marital status, years of education, years living in the U.S., and generalized anxiety, anxiety sensitivity significantly accounted for significant variance in pain intensity, inflexibility in relation to emotional distress, and life impairment. Overall, the current study builds upon what is currently understood about anxiety sensitivity among the Latinx population and uniquely extends past work by linking individual differences in this construct to clinically relevant aspects of pain experience and life impairment among adults attending FQHC's. Additional clinical attention should be focused on anxiety sensitivity to offset pain disparities among this established health disparities group.

摘要

拉丁裔人口是美国最大的少数族裔群体,预计至少到 2050 年还会继续增长。尽管人们越来越认识到拉丁裔个体的疼痛的重要性,但很少有研究探讨过影响拉丁裔人群疼痛严重程度和残疾的个体化心理过程。在与疼痛体验特别是与临床疾病相关的方面,有一种心理因素显示出了很大的希望,那就是焦虑敏感性。本研究旨在:(1) 描述参加联邦合格医疗中心(FQHC)的未选择的成年拉丁裔个体的疼痛严重程度;(2) 评估焦虑敏感性作为疼痛严重程度的一个函数的严重程度;(3) 测试焦虑敏感性作为个体差异因素对疼痛强度、疼痛残疾、对情绪困扰的心理不灵活性和整体生活损害的潜在解释相关性。参与者包括 406 名讲西班牙语的成年拉丁裔人(87.2%为女性;M=40.26 岁,SD=11.20 岁,98.3%的人将西班牙语作为第一语言),他们参加了德克萨斯州休斯顿的一个 FQHC。分析结果显示,该样本中有 62.6%的人有一定程度的疼痛,21.9%的人有高强度、中度干扰或严重干扰的慢性疼痛。此外,结果还提供了焦虑敏感性作为疼痛等级的函数的证据,即患有 2 级(高强度疼痛)、3 级(中度疼痛干扰)和 4 级(严重疼痛干扰)慢性疼痛的个体比患有 0 级疼痛(无慢性疼痛)的个体报告了更高水平的焦虑敏感性。此外,在控制年龄、性别、婚姻状况、受教育年限、在美国居住年限和广泛性焦虑后,焦虑敏感性显著解释了疼痛强度、与情绪困扰相关的不灵活性以及生活损害的显著差异。总的来说,本研究建立在目前对拉丁裔人群焦虑敏感性的理解基础上,通过将该构念的个体差异与参加 FQHC 的成年人的疼痛体验和生活损害的临床相关方面联系起来,从而在这方面的研究工作中独树一帜。应该更加关注焦虑敏感性,以减轻这个既定的健康差异群体的疼痛差异。

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