Differences in Pain Experience Among Different Racial and Ethnic Groups.

IF 3.5 4区 医学 Q1 ORTHOPEDICS Physical Therapy Pub Date : 2024-10-02 DOI:10.1093/ptj/pzae001
Elizabeth Lane, Chris Barnes, Julie M Fritz
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Abstract

Objective: The objective of this study was to examine the role of pain catastrophizing and pain self-efficacy as possible mediators of race-based differences in pain intensity and to evaluate the possible moderating role of race on the relationship between pain catastrophizing and pain self-efficacy with pain outcomes among persons with chronic spinal pain receiving physical therapy.

Methods: This study was a secondary analysis of a cluster-randomized trial. Participants were persons with chronic spinal pain in outpatient physical therapy clinics who consented to complete assessments at baseline and after 2 weeks and 12 weeks. Assessments included pain intensity, physical function, pain catastrophizing, and self-efficacy. Baseline comparisons between Black and non-Hispanic White participants were made. Mediation analyses used a regression-based framework to examine whether baseline pain catastrophizing and self-efficacy mediated the association between race and pain intensity. Moderation analyses used multiple linear regression to evaluate the role of race in the relationship of baseline pain catastrophizing and self-efficacy with 12-week pain intensity outcomes.

Results: A total of 274 participants were included (51 [18.6%] Black and 223 [81.4%] non-Hispanic White; mean age = 51.6 years [standard deviation = 14.9]; 180 [65.7%] female). At baseline, Black participants had higher pain intensity scores (mean difference = 0.80; 95% CI =1.5 to 0.12). Both pain catastrophizing and self-efficacy mediated the relationship between race and baseline pain intensity. Race moderated the relationships between baseline pain catastrophizing and self-efficacy and 12-week pain intensity scores.

Conclusion: Pain catastrophizing and self-efficacy had differential impacts on pain intensity based on race for both cross-sectional and longitudinal analyses among persons receiving physical therapy for chronic spinal pain.

Impact: Improved understanding of the differences in pain experience based on factors such as race, ethnicity, cultural background, and experience with the health care system may help reduce disparities in pain management.

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不同种族和族裔群体的疼痛体验差异。
研究目的本研究旨在探讨疼痛灾难化和疼痛自我效能感在疼痛强度种族差异中可能起到的中介作用,并评估种族在疼痛灾难化和疼痛自我效能感与接受物理治疗的慢性脊柱疼痛患者的疼痛结果之间可能起到的调节作用:本研究是对一项分组随机试验的二次分析。参与者为门诊物理治疗诊所的慢性脊柱疼痛患者,他们同意在基线期以及 2 周和 12 周后完成评估。评估内容包括疼痛强度、身体功能、疼痛灾难化和自我效能。对黑人和非西班牙裔白人参与者进行了基线比较。中介分析采用了基于回归的框架,以研究基线疼痛灾难化和自我效能是否对种族和疼痛强度之间的关联起中介作用。调节分析使用多元线性回归来评估种族在基线疼痛灾难化和自我效能与 12 周疼痛强度结果之间的关系:共纳入 274 名参与者(51 名 [18.6%] 黑人和 223 名 [81.4%] 非西班牙裔白人;平均年龄 = 51.6 岁 [SD = 14.9];180 名 [65.7%] 女性)。基线时,黑人参与者的疼痛强度得分更高(平均差异 = 0.80;95% CI = 1.5 至 0.12)。疼痛灾难化和自我效能对种族和基线疼痛强度之间的关系起到了中介作用。种族调节了基线疼痛灾难化和自我效能与12周疼痛强度评分之间的关系:结论:在对接受物理治疗的慢性脊柱疼痛患者进行横断面和纵向分析时,疼痛灾难化和自我效能感对疼痛强度的影响因种族而异:影响:进一步了解基于种族、民族、文化背景和医疗保健系统经验等因素的疼痛体验差异,有助于减少疼痛治疗中的差异。
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来源期刊
Physical Therapy
Physical Therapy Multiple-
CiteScore
7.10
自引率
0.00%
发文量
187
审稿时长
4-8 weeks
期刊介绍: Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.
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