H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine and Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX.
Department of Family and Community Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL.
Arch Phys Med Rehabil. 2023 Jul;104(7):1099-1106. doi: 10.1016/j.apmr.2023.03.003. Epub 2023 Mar 24.
To investigate catastrophizing and self-efficacy for managing pain among Non-Hispanic Whites, Non-Hispanic Blacks, and Hispanics with chronic pain after traumatic brain injury (TBI), and whether coping interacts with race/ethnicity to predict participation outcomes.
Community after discharge from inpatient rehabilitation.
621 individuals with moderate to severe TBI and chronic pain, who completed follow-up as part of a national longitudinal study of TBI and also participated in a collaborative study on chronic pain.
Multicenter, cross-sectional, survey study.
Catastrophizing subscale from the Coping With Pain Scale; Pain Self-Efficacy Questionnaire; Participation Assessment With Recombined Tools-Objective.
After controlling for relevant sociodemographic variables, a significant interaction was observed between race/ethnicity and insurance status, such that Blacks who had public health insurance reported greater catastrophizing in response to pain compared with Whites. Race/ethnicity and self-efficacy for managing pain were unrelated. Greater catastrophizing was associated with lower participation but did not interact with race/ethnicity. Blacks reported lower participation relative to Whites, independent of catastrophizing.
Black individuals who have TBI and chronic pain, and who have public insurance, may be vulnerable to difficulties managing pain. They are more likely to cope by catastrophizing, and catastrophizing is related to worse participation outcomes. The results suggest that access to care may affect response to chronic pain after TBI.
调查非西班牙裔白人、非西班牙裔黑人和西班牙裔慢性创伤性脑损伤（TBI）患者的灾难化和管理疼痛的自我效能，以及应对方式是否与种族/民族相互作用，从而预测参与结果。
住院康复后出院到社区。
621 名中重度 TBI 和慢性疼痛患者，他们作为 TBI 国家纵向研究的一部分完成了随访，并且还参加了慢性疼痛的合作研究。
多中心、横断面、调查研究。
疼痛量表的灾难化分量表；疼痛自我效能问卷；使用重组工具进行的参与评估-客观。
在控制了相关社会人口统计学变量后，观察到种族/民族和保险状况之间存在显著的相互作用，即拥有公共医疗保险的黑人在应对疼痛时比白人报告了更大的灾难化。种族/民族和管理疼痛的自我效能之间没有关系。更大的灾难化与较低的参与度相关，但与种族/民族没有相互作用。无论灾难化程度如何，黑人报告的参与度都低于白人。
患有 TBI 和慢性疼痛且拥有公共保险的黑人可能容易出现疼痛管理困难。他们更有可能通过灾难化来应对，而灾难化与较差的参与结果相关。结果表明，获得医疗保健可能会影响 TBI 后慢性疼痛的反应。
