Buckley Lisa, Sterling Michele, Elphinston Rachel A
School of Public Health, The University of Queensland, Brisbane, Australia.
RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia.
Pain. 2023 Feb 1;164(2):435-442. doi: 10.1097/j.pain.0000000000002724. Epub 2022 Apr 7.
The impacts of COVID-19 and imposed restrictions on individuals with chronic noncancer pain continue to emerge, varying across countries. More recent research (including with longitudinal designs) suggests that the pandemic may not have such a disproportionate effect on chronic noncancer pain and its management as first thought. This longitudinal study, with assessments before the pandemic (2019) and early during the pandemic (May-July 2020), examined changes in validated measures of pain severity, pain interference, prescription opioid misuse, and mental health symptoms. Patients (N = 236) self-reported significant improvements in pain severity, pain interference, pain self-efficacy, pain catastrophizing, prescription opioid misuse, depression, and anxiety symptoms over time. Approximately 30% and 33% of patients achieved minimally important reductions (10% change) in pain severity and pain interference, respectively. In follow-up exploratory analyses, prepandemic sociodemographic and psychological factors predictive of 10% improved (vs 10% worse) pain severity and interference were investigated in logistic regressions. Reduction in pain interference was predicted by current employment, older age, and higher pain self-efficacy. There were no significant predictors of reduction in pain severity. The impact of COVID-19 on patients' pain experience and mental health was negligible in the early stages of the pandemic, and findings suggest improvements through the period. Targeted interventions that promote the protective factor of pain self-efficacy and build resilience may buffer patients' future response to the pandemic because it evolves as a part of our new normal. Targeted social determinants of health interventions that direct resources toward maintaining employment could also be important.
2019冠状病毒病（COVID-19）及其相关限制措施对慢性非癌性疼痛患者的影响仍在不断显现，且因国家而异。最近的研究（包括纵向研究设计）表明，这场大流行对慢性非癌性疼痛及其管理的影响可能并不像最初认为的那样具有不成比例的影响。这项纵向研究在大流行之前（2019年）和大流行早期（2020年5月至7月）进行了评估，考察了疼痛严重程度、疼痛干扰、处方阿片类药物滥用和心理健康症状等经过验证的指标的变化。患者（N = 236）自我报告称，随着时间的推移，疼痛严重程度、疼痛干扰、疼痛自我效能感、疼痛灾难化、处方阿片类药物滥用、抑郁和焦虑症状都有显著改善。分别约有30%和33%的患者在疼痛严重程度和疼痛干扰方面实现了最小重要程度的降低（变化10%）。在后续的探索性分析中，在逻辑回归中研究了大流行前预测疼痛严重程度和干扰改善10%（与恶化10%相比）的社会人口统计学和心理因素。目前就业、年龄较大和较高的疼痛自我效能感可预测疼痛干扰的降低。疼痛严重程度降低没有显著的预测因素。在大流行的早期阶段，COVID-19对患者疼痛体验和心理健康的影响可以忽略不计，研究结果表明在此期间有所改善。随着大流行成为我们新常态的一部分而不断演变，促进疼痛自我效能感这一保护因素并增强恢复力的针对性干预措施可能会缓冲患者未来对大流行的反应。将资源导向维持就业的有针对性的健康社会决定因素干预措施也可能很重要。
