通过两波和密集的纵向数据探讨灾难化与子宫内膜异位症疼痛之间的相互作用。

IF 2.9 3区 医学 Q1 ANESTHESIOLOGY Pain Medicine Pub Date : 2024-12-28 DOI:10.1093/pm/pnae132
Marcelo França Moreira, Marco Aurelio Pinho Oliveira
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引用次数: 0

摘要

背景:子宫内膜异位症以子宫外存在子宫内膜样组织为特征,可导致慢性盆腔疼痛。然而,仅凭病变特征并不能完全解释子宫内膜异位症相关疼痛的复杂性。疼痛灾难化是一种影响疼痛感知的认知过程,传统上通过横断面或双波设计进行研究,难以捕捉其与子宫内膜异位症疼痛的动态相互作用。为了解决这些差距,我们的研究探索了疼痛灾难和疼痛结果之间的双向关系——包括强度、频率和耀斑——在详细的四周时间内,在总共30天的时间框架内,跨越感官和情感维度。方法:一个潜在的生长曲线模型评估疼痛灾难,初始疼痛水平和子宫内膜异位症疼痛轨迹之间的关系超过四周。此外,四个中介模型探讨了基线疼痛灾难化如何影响疼痛的各个方面,包括感觉和情感维度,以及它对疼痛灾难化的后续影响。结果:结果表明,高水平的疼痛灾难显著加剧了子宫内膜异位症的疼痛超过四周,影响了平均疼痛强度、发作频率和30天内的发作。疼痛灾难化也对感觉和情感维度产生不利影响。这些因素部分介导基线疼痛灾难化在第5周水平上的影响,揭示了一种双向关系。值得注意的是,情感维度放大了随后的痛苦灾难化,而感觉维度则产生了相反的负面影响。结论:本研究强调了疼痛灾难化与子宫内膜异位症相关疼痛的几个方面之间的双向影响。感觉和情感维度起着不同的作用,对个性化干预有影响。局限性和临床相关性进行了讨论。
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Exploring the Interplay Between Catastrophizing and Endometriosis Pain Through Two-Wave and Intensive Longitudinal Data.

Background: Endometriosis, characterized by the presence of endometrial-like tissue outside the uterus, results in chronic pelvic pain. However, lesion characteristics alone cannot fully explain the complexity of endometriosis-related pain. Pain catastrophizing, a cognitive process that influences pain perception, has traditionally been studied through cross-sectional or two-wave designs, which struggle to capture its dynamic interplay with endometriosis pain. To address these gaps, our study explores the bidirectional relationship between pain catastrophizing and pain outcomes-including intensity, frequency, and flares-over a detailed four-week period, an aggregated 30-day timeframe, and across sensory and affective dimensions.

Methods: A Latent Growth Curve Model assessed the relationship between pain catastrophizing, initial pain levels, and endometriosis pain trajectories over four weeks. Additionally, four mediator models explored how baseline pain catastrophizing affects various pain aspects, including sensory and affective dimensions, and its subsequent influence on pain catastrophizing.

Results: Results indicate that high levels of pain catastrophizing significantly escalate endometriosis pain over four weeks, affecting average pain intensity, episode frequency, and flares over 30 days. Pain catastrophizing also adversely impacts sensory and affective dimensions. These elements partially mediate baseline pain catastrophizing's effect on week five levels, revealing a bidirectional relationship. Notably, while the affective dimension amplifies subsequent pain catastrophizing, the sensory dimension exerts a contrasting negative influence.

Conclusion: The study highlights the bidirectional influence between pain catastrophizing and several aspects of endometriosis-related pain. Sensory and affective dimensions play distinct roles, with implications for personalized interventions. Limitations and clinical relevance are discussed.

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来源期刊
Pain Medicine
Pain Medicine 医学-医学:内科
CiteScore
6.50
自引率
3.20%
发文量
187
审稿时长
3 months
期刊介绍: Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.
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