Rabey Martin, Buldo Brendan, Duesund Helland Magnus, Pang Courtenay, Kendell Michelle, Beales Darren
Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia.
Thrive Physiotherapy, Guernsey.
Br J Pain. 2022 Jun;16(3):326-340. doi: 10.1177/20494637211062045. Epub 2021 Dec 27.
Back pain is complex. Social support and significant other interactions influence the pain experience. To statistically derive subgroups of people with chronic low back pain based upon their interactions with significant others, and profile subgroups across multidimensional variables. Longitudinal cohort study. People with chronic axial low back pain ( = 262). Latent class analysis of significant other interaction data was used to derive subgroups of people with chronic low back pain. Subgroups were profiled across baseline multidimensional variables and one-year follow-up pain intensity, disability and bothersomeness. Three clusters were identified: Cluster 1 (7.6%) characterised by the lowest distracting, punishing and solicitous interactions. Cluster 2 (16.0%) characterised by the highest distracting and solicitous responses and social support. Cluster 3 (76.3%) characterised by the highest punishing and lowest social support. Cluster 1 reported less disability than Clusters 2 and 3. Mindfulness was significantly different across all subgroups with Cluster 1 being most mindful and Cluster 3 least mindful. Depression, anxiety and stress were significantly higher in Cluster 3 than Cluster 1. Pain catastrophising was higher for Cluster 2 than Clusters 1 and 3. Cluster 2 had lower pressure pain threshold than Clusters 1 and 3. These results support the association between significant other interactions and the experience of back pain. Considering significant other interactions in clinical practice may be important for managing some people's presentation.
背痛情况复杂。社会支持及与重要他人的互动会影响疼痛体验。基于慢性下背痛患者与重要他人的互动情况，从统计学角度划分亚组，并描绘各亚组在多维变量方面的特征。纵向队列研究。慢性轴性下背痛患者（=262人）。运用对重要他人互动数据的潜在类别分析来划分慢性下背痛患者亚组。根据基线多维变量以及一年随访时的疼痛强度、残疾程度和困扰程度来描绘各亚组特征。确定了三个类别：类别1（7.6%）的特点是分散注意力、惩罚性和关切性互动最少；类别2（16.0%）的特点是分散注意力和关切性反应以及社会支持程度最高；类别3（76.3%）的特点是惩罚性最高且社会支持程度最低。类别1报告的残疾程度低于类别2和类别3。正念在所有亚组间存在显著差异，类别1正念程度最高，类别3最低。类别3中的抑郁、焦虑和压力显著高于类别1。类别2的疼痛灾难化程度高于类别1和类别3。类别2的压痛阈值低于类别1和类别3。这些结果支持了重要他人互动与背痛体验之间的关联。在临床实践中考虑重要他人的互动对于处理某些人的病情可能很重要。
