Wakaizumi Kenta, Tanaka Chisato, Shinohara Yuta, Wu Yihuan, Takaoka Saki, Kawate Morihiko, Oka Hiroyuki, Matsudaira Ko
Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan.
Interdisciplinary Pain Center, Keio University Hospital, Tokyo, Japan.
Front Public Health. 2024 Dec 12;12:1482177. doi: 10.3389/fpubh.2024.1482177. eCollection 2024.
A geographical analysis could be employed to uncover social risk factors and interventions linked to chronic pain. Nonetheless, geographical variation in chronic pain across different regions of Japan have not been well explored. This study aims to investigate geographical variation in high-impact chronic pain (HICP), defined as moderate to severe chronic pain, and examine the associated psychological factors at the prefecture level.
A cross-sectional Internet-based survey involving 52,353 participants was conducted to assess chronic pain conditions, stress levels, mood states, educational levels, living status, regions, sleep duration, and exercise habits. A geographical analysis evaluated the prevalence of HICP at the prefecture level, and a multilevel analysis explored the risk factors for HICP at both individual and prefecture levels.
The geographical analysis revealed that Fukushima exhibited the highest HICP prevalence (23.2%; -score = 2.11), Oita ranked second (23.0%; -score = 2.00), and Okinawa showed the lowest prevalence (14.9%; -score = -2.45). Geographical maps of Japan indicated that regional-level subjective stress, negative emotions, and short sleep were associated with higher HICP prevalence. In contrast, positive emotions, such as vigor, were associated with lower prevalence. Multilevel analysis revealed a significant improvement in model fit after incorporating psychological factors at the prefecture level ( < 0.001) and identified significant associations between high subjective stress and low vigor at the prefecture level with HICP prevalence ( < 0.001).
There are regional differences in HICP prevalence, and at the prefecture level, subjective stress and vigor are associated with HICP.
地理分析可用于揭示与慢性疼痛相关的社会风险因素和干预措施。然而，日本不同地区慢性疼痛的地理差异尚未得到充分研究。本研究旨在调查高影响慢性疼痛（HICP，定义为中度至重度慢性疼痛）的地理差异，并在县级层面检查相关的心理因素。
进行了一项基于互联网的横断面调查，涉及52353名参与者，以评估慢性疼痛状况、压力水平、情绪状态、教育水平、生活状况、地区、睡眠时间和运动习惯。地理分析评估了县级层面HICP的患病率，多层次分析探讨了个体和县级层面HICP的风险因素。
地理分析显示，福岛的HICP患病率最高（23.2%；Z分数=2.11），大分县排名第二（23.0%；Z分数=2.00），冲绳的患病率最低（14.9%；Z分数=-2.45）。日本的地理地图表明，地区层面的主观压力、负面情绪和短睡眠与较高的HICP患病率相关。相比之下，积极情绪，如活力，与较低的患病率相关。多层次分析显示，在纳入县级层面的心理因素后，模型拟合有显著改善（P<0.001），并确定县级层面的高主观压力和低活力与HICP患病率之间存在显著关联（P<0.001）。
HICP患病率存在地区差异，在县级层面，主观压力和活力与HICP相关。
