Axon David Rhys, Smith Jonan
Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85721.
Medicine (Baltimore). 2024 Dec 13;103(50):e40949. doi: 10.1097/MD.0000000000040949.
Self-perceived health is related to outcomes such as morbidity and mortality. However, little is known about the relationship between pain severity and self-perceived health, which could be useful to know to help improve health. This study assessed the association of pain severity and other contributing factors with self-perceived health among United States adults. This cross-sectional, retrospective database study used 2019 Medical Expenditure Panel Survey data and included United States adults aged ≥18 years who responded to the pain item in the survey. The independent variable was self-reported pain severity, and the dependent variable was self-perceived health. Various potentially confounding variables were controlled for in the analysis. Adjusted logistic regression models were used to identify statistical associations between each variable and self-perceived health. The complex survey design was maintained, while nationally representative estimates were obtained. Among the sample of 17,261 United States adults, 88.1% (95% confidence interval, 87.4%-88.8%) reported excellent, very good, or good self-perceived health, while 11.9% (95% confidence interval, 11.2%-12.6%) reported fair or poor self-perceived health. In adjusted analyses, there were significant associations between fair or poor self-perceived health and any level of pain severity versus no pain, age 40 to 64 versus 18 to 39 years, male versus female, Hispanic versus non-Hispanic, high school diploma or less versus more than high school, unemployed versus employed, poor, near poor, or low versus middle or high income, fair or poor versus excellent, very good, or good mental health, exercising <5 times versus ≥5 times per week, smoker versus nonsmoker, and ≥2 versus <2 comorbid conditions. This study found that greater levels of pain severity (and several other variables) were associated with greater odds of reporting fair or poor self-perceived health. These associations provide greater insight into the variables associated with self-perceived health, which may be useful targets to improve health.
自我认知健康与发病率和死亡率等结果相关。然而,关于疼痛严重程度与自我认知健康之间的关系却知之甚少,了解这一关系可能有助于改善健康状况。本研究评估了美国成年人中疼痛严重程度及其他相关因素与自我认知健康之间的关联。这项横断面回顾性数据库研究使用了2019年医疗支出面板调查数据,纳入了年龄≥18岁且在调查中回答了疼痛问题的美国成年人。自变量是自我报告的疼痛严重程度,因变量是自我认知健康。分析中控制了各种潜在的混杂变量。采用调整后的逻辑回归模型来确定每个变量与自我认知健康之间的统计关联。在保持复杂调查设计的同时,获得了具有全国代表性的估计值。在17261名美国成年人样本中,88.1%(95%置信区间为87.4%-88.8%)报告自我认知健康状况为优秀、非常好或良好,而11.9%(95%置信区间为11.2%-12.6%)报告自我认知健康状况为一般或较差。在调整分析中,自我认知健康状况一般或较差与任何疼痛严重程度水平(与无疼痛相比)、40至64岁(与18至39岁相比)、男性(与女性相比)、西班牙裔(与非西班牙裔相比)、高中文凭及以下(与高中以上相比)、失业(与就业相比)、贫困、接近贫困或低收入(与中等或高收入相比)、心理健康状况一般或较差(与优秀、非常好或良好相比)、每周锻炼<5次(与≥5次相比)、吸烟者(与非吸烟者相比)以及≥2种(与<2种相比)合并症之间存在显著关联。本研究发现,较高水平的疼痛严重程度(以及其他几个变量)与报告自我认知健康状况一般或较差的较高几率相关。这些关联为与自我认知健康相关的变量提供了更深入的见解,这可能是改善健康状况的有用目标。