慢性疼痛、心理健康和在挪威重新安置的叙利亚成年难民的功能障碍：一项横断面研究。
Chronic pain, mental health and functional impairment in adult refugees from Syria resettled in Norway: a cross-sectional study.
机构信息
Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, 0484, Oslo, Norway.
Division for Mental and Physical Health, Norwegian Institute of Public Health, Skøyen, PO Box 222, 0213, Oslo, Norway.
出版信息
BMC Psychiatry. 2022 Aug 24;22(1):571. doi: 10.1186/s12888-022-04200-x.
BACKGROUND
Limited research exists on pain and especially the co-occurrence of pain and mental ill health in general refugee populations. The present study aimed to approximate the prevalence of chronic pain (CP) among adult refugees from Syria resettled in Norway; investigate the association between CP and mental ill health; and explore how CP and mental ill health associate with both perceived general health and functional impairment. Gender as potential effect modifier in these associations was also examined.
METHODS
Cross-sectional, postal survey questionnaire.
INCLUSION CRITERIA
≥ 18 years old; refugee from Syria; and arrived in Norway between 2015 and 2017. Study sample was randomly drawn from full population registries, and n = 902 participated (participation rate ≈10%). CP was measured with 10 items on pain lasting for ≥ 3 consecutive months last year. Symptoms of anxiety, depression and PTSD were measured with the HSCL and HTQ scales, respectively. Ordered and binomial logistic regressions were used in analyses. Gender was tested as effect modifier with Wald test for interaction.
RESULTS
In the sample overall, the proportion of participants who reported severe CP was 43.1%. There was strong evidence that anxiety, depression and PTSD were associated with higher levels of CP. In fully adjusted regression models, including both CP and mental health variables, CP was strongly associated with poor perceived general health whereas mental health showed much weaker associations. The association between mental health (anxiety and PTSD) and functional impairment was highly gender specific, with strong associations in men but not in women. CP was strongly associated with functional impairment with no difference across gender.
CONCLUSION
The study shows a high burden of CP in a general population of adult refugees from Syria with likely substantial adverse consequences for daily functioning. The strong association between CP and mental ill health suggests personnel working with refugees' health should be attuned to their co-occurrence as both problems may need to be addressed for either to be effectively mitigated. A clear mismatch exists between the burden on health caused by pain in general refugee populations and the amount of available evidence to guide mitigating strategies.
TRIAL REGISTRATION
NCT03742128.
背景
关于疼痛，尤其是一般难民群体中疼痛与精神健康不良同时发生的研究非常有限。本研究旨在估算在挪威重新安置的叙利亚成年难民中慢性疼痛（CP）的患病率；调查 CP 与精神健康不良之间的关系；并探讨 CP 和精神健康不良如何与整体健康感知和功能障碍相关。还检查了性别在这些关联中的潜在调节作用。
方法
横断面，邮寄问卷调查。
纳入标准
年龄≥18 岁；来自叙利亚的难民；并于 2015 年至 2017 年期间抵达挪威。研究样本是从全部人口登记册中随机抽取的，共有 902 人参与（参与率≈10%）。CP 通过去年持续 3 个月以上的 10 项疼痛项目来衡量。焦虑、抑郁和 PTSD 症状分别用 HSCL 和 HTQ 量表来衡量。分析采用有序和二项逻辑回归。用 Wald 检验检验性别作为效应修饰剂。
结果
在总体样本中，报告严重 CP 的参与者比例为 43.1%。有强有力的证据表明，焦虑、抑郁和 PTSD 与更高水平的 CP 相关。在包括 CP 和心理健康变量的完全调整回归模型中，CP 与较差的整体健康感知密切相关，而心理健康的相关性要弱得多。心理健康（焦虑和 PTSD）与功能障碍之间的关联具有高度性别特异性，男性关联较强，而女性则没有。CP 与功能障碍密切相关，与性别无关。
结论
研究表明，来自叙利亚的成年难民总体人群中 CP 负担沉重，这可能对日常功能产生重大不利影响。CP 与精神健康不良之间的强烈关联表明，从事难民健康工作的人员应该关注两者的同时发生，因为要有效缓解任何一种问题，都需要同时解决这两种问题。疼痛对一般难民群体健康造成的负担与指导缓解策略的现有证据量之间存在明显不匹配。
试验注册
NCT03742128。
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