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生物治疗类风湿关节炎患者的疼痛:COVID-19 大流行前后疾病认知的作用。

Pain in Biologic-Treated Rheumatoid Arthritis Patients: The Role of Illness Perception Before and After the COVID-19 Pandemic.

机构信息

Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.

Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

Musculoskeletal Care. 2024 Dec;22(4):e1958. doi: 10.1002/msc.1958.

Abstract

BACKGROUND

We aimed to assess the role of the COVID-19 pandemic in the association of clinical, physical, and psychological factors with pain in Rheumatoid Arthritis (RA) patients.

METHODS

We included 103 RA patients (81.6% females; mean age 56.1 ± 13.8 years). Patients filled out the VAS-pain, GAD-7, PHQ-9, MFI-20, and B-IPQ. Paired sample t-tests, correlations, and multiple regression analyses were used to analyse the data.

RESULTS

Our results showed significantly worsened pain in the data collected post-pandemic (p ≤ 0.05). Pre-pandemic, the final regression models showed an association between functional disability (β = 0.24; p ≤ 0.05), illness perception (β = 0.34; p ≤ 0.05) and pain. In post-pandemic models, significant associations were found between fatigue (β = 0.33; p ≤ 0.01) and illness perception (β = 0.36; p ≤ 0.01) with pain. Positive illness perception was able to alleviate the associations between fatigue and depression with pain before and after the pandemic.

CONCLUSION

Findings indicate that patients with RA may have been negatively affected by the COVID-19 pandemic given their vulnerability. Even though pharmacological treatment was not interrupted, post-pandemic results showed significantly higher levels of experienced pain. Therefore, in addition to biological therapy, non-pharmacological interventions, including psychological support aimed at diminishing negative illness perception, may be beneficial in reducing RA-related pain, especially when dealing with a crisis.

摘要

背景

我们旨在评估 COVID-19 大流行对临床、身体和心理因素与类风湿关节炎(RA)患者疼痛之间关联的影响。

方法

我们纳入了 103 例 RA 患者(81.6%为女性;平均年龄 56.1±13.8 岁)。患者填写了 VAS 疼痛量表、GAD-7、PHQ-9、MFI-20 和 B-IPQ。采用配对样本 t 检验、相关性和多元回归分析来分析数据。

结果

我们的结果显示,在疫情后收集的数据中疼痛明显恶化(p≤0.05)。在疫情前,最终的回归模型显示功能障碍(β=0.24;p≤0.05)和疾病认知(β=0.34;p≤0.05)与疼痛相关。在疫情后的模型中,疲劳(β=0.33;p≤0.01)和疾病认知(β=0.36;p≤0.01)与疼痛之间存在显著关联。积极的疾病认知可以减轻疫情前后疲劳和抑郁与疼痛之间的关联。

结论

研究结果表明,RA 患者可能因脆弱性而受到 COVID-19 大流行的负面影响。尽管药物治疗没有中断,但疫情后的结果显示疼痛水平显著升高。因此,除了生物治疗外,非药物干预措施,包括旨在减轻负面疾病认知的心理支持,可能有助于减轻 RA 相关疼痛,尤其是在应对危机时。

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