Center for Healthy Aging, Self-Management, & Complex Care, College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH, 43210, USA.
Department of Orthopedics, Miller School of Medicine, U Health Sports Medicine Institute, U of Miami, Coral Gables, FL, USA.
Rheumatol Int. 2024 Nov;44(11):2539-2546. doi: 10.1007/s00296-023-05396-1. Epub 2023 Aug 19.
Knee osteoarthritis (KOA) is a chronic disease accompanied by debilitating symptoms including pain, stiffness, and limited physical functionality, which have been shown to be associated with pain catastrophizing. Previous studies have revealed racial discrepancies in pain catastrophizing, notably between Hispanics and non-Hispanics while pointing to potential health disparities. Using a conceptual model, this study aimed to investigate racial differences in associations between KOA symptoms with specific pain catastrophizing domains (rumination, magnification, and helplessness). Patients with KOA (n = 253; 147 Hispanics, 106 non-Hispanic Whites) completed a survey that included measures of knee symptoms, pain catastrophizing, and demographic variables. Structural equation modeling revealed that among Hispanics, each pain catastrophizing domain (rumination, magnification, and helplessness) was associated with at least two symptomatic experiences, including pain severity and difficulty in physical function. Specifically, pain severity was associated with (a) rumination: β = 0.48, p < 0.001, (b) magnification: β = 0.31, p = 0.003; and (c) helplessness: β = 0.39, p < 0.001). Additionally, a lower score in physical function was associated with higher magnification (β = 0.26, p = 0.01), and helplessness (β = 0.25, p = 0.01). Among non-Hispanic White patients, pain severity was further associated with two domains of pain catastrophizing, including rumination (β = 0.39, p < 0.001) and helplessness (β = 0.35, p = 0.01). In addition, association pathways for demographic variables revealed that older Hispanics experienced greater challenges with higher pain severity (β = 0.26, p = 0.01) and greater difficulty with physical function (β = 0.31, p < 0.001) while Hispanics females experienced higher pain (β = 0.19, p = 0.03). These findings highlight the importance of designing tailored interventions that consider key demographic factors such as age, and gender, to improve physical function that might alleviate pain catastrophizing among Hispanics with KOA.
膝骨关节炎(KOA)是一种慢性疾病,伴有疼痛、僵硬和身体功能受限等衰弱症状,这些症状已被证明与疼痛灾难化有关。先前的研究表明,疼痛灾难化在种族之间存在差异,尤其是在西班牙裔和非西班牙裔之间,同时也指出了潜在的健康差距。本研究使用概念模型,旨在探讨 KOA 症状与特定疼痛灾难化领域(反刍、放大和无助)之间的关联在种族上的差异。共有 253 名 KOA 患者(147 名西班牙裔,106 名非西班牙裔白人)完成了一项调查,该调查包括膝关节症状、疼痛灾难化和人口统计学变量的测量。结构方程模型显示,在西班牙裔中,每个疼痛灾难化领域(反刍、放大和无助)都与至少两种症状体验相关,包括疼痛严重程度和身体功能障碍。具体而言,疼痛严重程度与(a)反刍:β=0.48,p<0.001,(b)放大:β=0.31,p=0.003;和(c)无助:β=0.39,p<0.001)有关。此外,身体功能的得分越低,与更高的放大(β=0.26,p=0.01)和无助(β=0.25,p=0.01)有关。在非西班牙裔白人患者中,疼痛严重程度与疼痛灾难化的两个领域进一步相关,包括反刍(β=0.39,p<0.001)和无助(β=0.35,p=0.01)。此外,人口统计学变量的关联途径表明,年龄较大的西班牙裔患者在疼痛严重程度(β=0.26,p=0.01)和身体功能障碍(β=0.31,p<0.001)方面面临更大的挑战,而西班牙裔女性患者则经历更高的疼痛(β=0.19,p=0.03)。这些发现强调了设计量身定制的干预措施的重要性,这些干预措施需要考虑年龄和性别等关键人口统计学因素,以改善 KOA 西班牙裔患者的身体功能,从而减轻他们的疼痛灾难化。