School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
PLoS One. 2023 Mar 17;18(3):e0283222. doi: 10.1371/journal.pone.0283222. eCollection 2023.
Psychosocial resources, psychological and social factors like self-efficacy and social support have been suggested as important assets for individuals with chronic pain, but the importance of psychosocial resources for the development of pain is sparsely examined, especially sex and gender differences. The aim of this study was to investigate associations between psychosocial resources and sex on the development of frequent pain in a general population sample, and to deepen the knowledge about sex and gender patterns.
A sample from the Swedish Health Assets Project, a longitudinal cohort study, included self-reported data from 2263 participants, 53% women, with no frequent pain at baseline. The outcome variable was frequent pain at 18-months follow-up. Psychosocial resources studied were general self-efficacy, instrumental and emotional social support. Log binomial regressions in a generalised linear model were used to calculate risk ratios (RRs), comparing all combinations of men with high psychosocial resources, men with low psychosocial resources, women with high psychosocial resources and women with low psychosocial resources.
Women with low psychosocial resources had higher risk of frequent pain at follow-up compared to men with high resources: general self-efficacy RR 1.82, instrumental social support RR 2.33 and emotional social support RR 1.94. Instrumental social support was the most important protective resource for women, emotional social support was the most important one for men. Results were discussed in terms of gender norms.
The psychosocial resources general self-efficacy, instrumental and emotional support predicted the risk of developing frequent pain differently among and between men and women in a general population sample. The results showed the importance of studying sex and gender differences in psychological and not least social predictors for pain.
心理社会资源、自我效能感和社会支持等心理和社会因素被认为是慢性疼痛患者的重要资产,但心理社会资源对疼痛发展的重要性研究甚少,尤其是性别差异。本研究旨在调查一般人群样本中心理社会资源与性别对频繁疼痛发展的关联,并深入了解性别模式。
一项来自瑞典健康资产项目的纵向队列研究的样本包括 2263 名参与者的自我报告数据,其中 53%为女性,基线时无频繁疼痛。因变量为 18 个月随访时的频繁疼痛。研究的心理社会资源包括一般自我效能感、工具性和情感性社会支持。使用广义线性模型中的对数二项式回归计算风险比 (RR),比较男性高心理社会资源组、男性低心理社会资源组、女性高心理社会资源组和女性低心理社会资源组的所有组合。
与男性高资源相比,女性低心理社会资源者在随访时发生频繁疼痛的风险更高:一般自我效能 RR 为 1.82,工具性社会支持 RR 为 2.33,情感性社会支持 RR 为 1.94。工具性社会支持是女性最重要的保护资源,情感性社会支持是男性最重要的资源。结果从性别规范的角度进行了讨论。
一般人群样本中,心理社会资源一般自我效能感、工具性和情感支持对男性和女性发生频繁疼痛的风险有不同的预测作用。研究结果表明,研究心理和社会预测因素对疼痛的性别差异非常重要。