Tidmarsh Lydia V, Harrison Richard, Wilkinson Harriet, Harrington Megan, Ravindran Deepak, Norwood Sally, Finlay Katherine A
School of Psychology and Clinical Language Sciences, University of Reading, UK.
Centre for Integrative Neuroscience and Neurodynamics, University of Reading, UK.
Br J Pain. 2025 Sep 12:20494637251377761. doi: 10.1177/20494637251377761.
Waiting lists for pain management services globally are extensive, exacerbating the burden of chronic pain for patients and service providers. This study aimed to examine the psychological profiles of people living with chronic pain (PLwCP) during long treatment delay and use appropriate inferential analyses of waitlist data to identify potential demographic characteristics presenting at-risk subgroups.
A longitudinal survey design tracked measures of psychological wellbeing (pain self-efficacy, depression, anxiety and pain catastrophizing) in PLwCP ( = 211, Males = 50, Females = 161) on the waitlist for pain management, in a major regional NHS hospital in the Southeast of the UK. Measures were collected at baseline, three-months and six-months of waiting.
Regression and ANOVA models revealed that clinically significant levels of depression, anxiety, pain catastrophizing and pain self-efficacy remained high throughout the waiting period, indicating sustained psychological distress. While pain self-efficacy significantly increased over time and though the effect size was small, levels were in the clinically severe range throughout the wait-time, thus requiring intervention. Older and younger adults showed different phenotypical patterns of psychosocial wellbeing whilst waiting.
These findings demonstrate that clinical levels of psychological distress are persistent and entrenched throughout the waitlist for pain management. PLwCP remain an at-risk population in significant need of earlier support. Prehabilitation offers a prospective framework through which early intervention can be achieved. Subgroups identified as greater risk are younger individuals and those with worse depression, anxiety, pain catastrophizing and/or pain self-efficacy upon referral. These factors present stratification targets and direction of where prehabilitation is most urgently required. These findings have clear implications to improve pain practice.
全球疼痛管理服务的等候名单冗长，加重了患者和服务提供者的慢性疼痛负担。本研究旨在调查长期治疗延迟期间慢性疼痛患者（PLwCP）的心理状况，并对等候名单数据进行适当的推断分析，以确定存在风险亚组的潜在人口统计学特征。
采用纵向调查设计，对英国东南部一家主要的地区国民健康服务（NHS）医院中等待疼痛管理的PLwCP（n = 211，男性 = 50，女性 = 161）的心理健康指标（疼痛自我效能感、抑郁、焦虑和疼痛灾难化）进行跟踪测量。在等待的基线、三个月和六个月时收集测量数据。
回归模型和方差分析模型显示，在整个等待期间，抑郁、焦虑、疼痛灾难化和疼痛自我效能感的临床显著水平一直居高不下，表明心理困扰持续存在。虽然疼痛自我效能感随时间显著增加，且效应量较小，但在整个等待期间水平都处于临床严重范围内，因此需要进行干预。老年人和年轻人在等待期间表现出不同的心理社会幸福表型模式。
这些发现表明，在疼痛管理的等候名单中，临床水平的心理困扰是持续且根深蒂固的。PLwCP仍然是一个急需早期支持的高危人群。术前康复提供了一个可以实现早期干预的前瞻性框架。被确定为风险较高的亚组是较年轻的个体以及转诊时抑郁、焦虑、疼痛灾难化和/或疼痛自我效能感较差的个体。这些因素为术前康复最迫切需要的分层目标和方向提供了依据。这些发现对改善疼痛治疗实践具有明确的意义。
