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儒家文化背景下的颞下颌关节紊乱相关疼痛:与躯体疼痛、心理健康和痛苦的相互关系。

Painful temporomandibular disorders in Confucian-heritage cultures: Their inter-relationship with bodily pain, psychological well-being and distress.

机构信息

Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore City, Singapore.

National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore City, Singapore.

出版信息

J Oral Rehabil. 2023 Oct;50(10):948-957. doi: 10.1111/joor.13522. Epub 2023 Jun 7.

Abstract

BACKGROUND

Temporomandibular disorders (TMDs) are common and affect individuals negatively.

OBJECTIVES

This study investigated the inter-relationship of painful TMDs with bodily pain, psychological well-being and distress in young people from a Confucian-heritage culture (CHC).

METHODS

Adolescents/young adults were recruited from a polytechnic in Singapore. While the presence/severity of painful TMDs and bodily pain were established with the DC/TMD Pain Screener (TPS) and Maciel's Pain Inventory, psychological well-being and distress were evaluated with the Scales of Psychological Well-being-18 (SPWB-18) and Patient Health Questionnaire-4 (PHQ-4). Statistical explorations were conducted using chi-square/Mann-Whitney U tests, Spearman's correlation and logistic regression analyses (α = .05).

RESULTS

Among the 225 participants (mean age 20.1 ± 3.9 years) examined, 11.6% had painful TMDs and 68.9% experienced multisite bodily pain. Though painful TMDs were accompanied by a higher occurrence of multisite bodily pain, the overall/discrete number of bodily pain sites did not differ substantially between the 'no TMD pain' (NT) and 'with TMD pain' (WT) groups. Besides ear pain, differences in overall/discrete bodily pain scores were also insignificant. However, significant differences in environmental mastery, overall psychological distress, depression and anxiety subscale scores were discerned between the NT and WT groups. Psychological well-being and distress were moderately and negatively correlated (r  = -.56). Multivariate analysis indicated that ear pain and psychological distress increased the prospect of painful TMDs.

CONCLUSION

The prevalence of multi-site bodily pain was high in young people from CHCs irrespective of the painful TMDs' presence of painful TMDs. Enhancing environmental mastery and relieving depression/anxiety may help manage TMD pain.

摘要

背景

颞下颌关节紊乱(TMD)很常见,会对患者造成负面影响。

目的

本研究旨在探讨儒家文化背景下的年轻人中,压痛性 TMD 与躯体疼痛、心理幸福感和心理困扰的相互关系。

方法

从新加坡一所理工学院招募青少年/年轻人。使用 DC/TMD 疼痛筛查器(TPS)和 Maciel 的疼痛量表评估压痛性 TMD 和躯体疼痛的存在/严重程度,使用心理幸福感量表-18 项(SPWB-18)和患者健康问卷-4 项(PHQ-4)评估心理幸福感和心理困扰。使用卡方检验/曼-惠特尼 U 检验、斯皮尔曼相关系数和逻辑回归分析(α=0.05)进行统计分析。

结果

在 225 名参与者(平均年龄 20.1±3.9 岁)中,11.6%有压痛性 TMD,68.9%经历多部位躯体疼痛。尽管压痛性 TMD 伴随着更高的多部位躯体疼痛发生率,但在“无 TMD 疼痛”(NT)和“有 TMD 疼痛”(WT)组之间,总体/离散躯体疼痛部位的数量没有显著差异。除了耳痛外,总体/离散躯体疼痛评分的差异也不显著。然而,在 NT 和 WT 组之间,环境掌控、总体心理困扰、抑郁和焦虑分量表评分存在显著差异。心理幸福感和心理困扰呈中度负相关(r=-0.56)。多变量分析表明,耳痛和心理困扰增加了压痛性 TMD 的可能性。

结论

儒家文化背景下的年轻人多部位躯体疼痛的发生率较高,无论是否存在压痛性 TMD。增强环境掌控感和缓解抑郁/焦虑可能有助于管理 TMD 疼痛。

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