Department of General Internal Medicine, Cantonal Hospital Baden, Baden 5404, Switzerland.
Department of Internal Medicine, University Hospital Bern, Bern University, Bern 3010, Switzerland.
Pain Med. 2023 Sep 1;24(9):1066-1072. doi: 10.1093/pm/pnad055.
To assess the degree of resilience in patients with complex regional pain syndrome (CRPS) 1, to explore the relationship between resilience and patient-related outcome measurements and to describe a pattern of clinical manifestations associated with low resilience.
This study presents a cross-sectional analysis of baseline information collected from patients enrolled in a single center study between February 2019 and June 2021. Participants were recruited from the outpatient clinic of the Department of Physical Medicine & Rheumatology of the Balgrist University Hospital, Zurich, Switzerland. We used linear regression analysis to explore association of resilience with patient reported outcomes at baseline. Furthermore, we explored the impact of significant variables on the low degree resilience using logistic regression analysis.
Seventy-one patients (females 90.1%, mean age 51.2 ± 12.9 years) were enrolled. There was no association between CRPS severity and the level of resilience. Quality of Life was positively correlated with resilience, as was pain self-efficacy. Pain catastrophizing was inversely correlated with the level of resilience. We observed a significant inverse association between anxiety, depression and fatigue and the level of resilience. The proportion of patients with a low resilience increased with higher level of anxiety, depression and fatigue on the PROMIS-29, without reaching statistical significance.
Resilience seems to be an independent factor in CRPS 1 and is associated with relevant parameters of the condition. Therefore, caretakers may screen the current resilience status of CRPS 1 patients to offer a supplementary treatment approach. Whether specific resilience training modifies CRPS 1 course, requires further investigations.
评估复杂性区域疼痛综合征（CRPS）1 患者的适应能力，探讨适应能力与患者相关结局测量的关系，并描述与适应能力低相关的临床表现模式。
本研究为 2019 年 2 月至 2021 年 6 月在瑞士苏黎世巴尔格利斯特大学医院物理医学和风湿病科门诊招募的单中心研究的基线信息进行了横断面分析。我们使用线性回归分析来探讨基线时适应能力与患者报告结局的关系。此外，我们还使用逻辑回归分析探讨了显著变量对低适应能力的影响。
共纳入 71 名患者（女性 90.1%，平均年龄 51.2±12.9 岁）。CRPS 严重程度与适应能力水平之间无关联。生活质量与适应能力呈正相关，疼痛自我效能感也是如此。疼痛灾难化与适应能力呈负相关。我们观察到焦虑、抑郁和疲劳与适应能力呈显著负相关。在 PROMIS-29 上，焦虑、抑郁和疲劳水平越高，适应能力低的患者比例越高，但无统计学意义。
适应能力似乎是 CRPS 1 的一个独立因素，与该疾病的相关参数相关。因此，护理人员可能会对 CRPS 1 患者的当前适应能力状况进行筛查，以提供补充治疗方法。特定的适应能力训练是否会改变 CRPS 1 的病程，需要进一步研究。
