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OBJECTIVE: To examine the relationship between C-reactive protein (CRP) and knee pain, and further explore whether this association is mediated by obesity. METHODS: The population was derived from 1999 to 2004 National Health and Nutrition Examination Survey. Logistic regression was used to analyze the relationship between CRP and knee pain in three different models, and the linear trend was analyzed. A restricted cubic spline model to assess the nonlinear dose-response relationship between CRP and knee pain. Mediation analyses were used to assess the potential mediating role of obesity. Subgroup analyses and sensitivity analyses were performed to ensure robustness. RESULTS: Compared with adults with lower CRP (first quartile), those with higher CRP had higher risks of knee pain (odds ratio 1.39, 95% confidence interval 1.12-1.72 in third quartile; 1.56, 1.25-1.95 in fourth quartile) after adjusting for covariates (except body mass index [BMI]), and the proportion mediated by BMI was 76.10% (p < .001). BMI and CRP were linear dose-response correlated with knee pain. The odds ratio for those with obesity compared with normal to knee pain was 2.27 (1.42-3.65) in the first quartile of CRP, 1.99 (1.38-2.86) in the second, 2.15 (1.38-3.33) in the third, and 2.92 (1.72-4.97) in the fourth. CONCLUSION: Obesity mediated the systemic inflammation results in knee pain in US adults. Moreover, higher BMI was associated with higher knee pain risk in different degree CRP subgroups, supporting an important role of weight loss in reducing knee pain caused by systemic inflammation.
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Índice de Masa Corporal , Proteína C-Reactiva , Encuestas Nutricionales , Obesidad , Humanos , Obesidad/sangre , Obesidad/epidemiología , Obesidad/complicaciones , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Masculino , Femenino , Estudios Transversales , Persona de Mediana Edad , Adulto , Articulación de la Rodilla , Dolor/epidemiología , Dolor/sangre , Dolor/etiología , Artralgia/sangre , Artralgia/epidemiología , Artralgia/etiología , Anciano , Factores de Riesgo , Oportunidad RelativaRESUMEN
ABASTRACT Background: To study the association between pain and depression, its characteristics and related factors in chilean older adults. METHODS: Cross-sectional analytical study of the National Survey of Dependence in Chilean older adults 2009, with a sample of 4766 people aged 60 years and older. Pain was described using a Likert scale from "no pain" to "very much pain". Depression was measured using the GDS-15 scale. Adjusted logistic regression analyses were performed to identify the association between pain and depression. RESULTS: 70% of the sample reported pain, 21.6% of high intensity. The screening was positive for depression in 23% of the sample, and 5% suspected severe depression. Both conditions were more frequent in women, subjects with low levels of schooling and rural residence. There was an association between pain and depression OR 3.46. The greater the intensity of pain, the greater the association OR 5.2 (95% CI 4.1-6.7) for depressive symptoms and OR 13.9 for suspected severe depression (95% CI 8.1-23.9). CONCLUSION: The association between pain and depression is high and is related to pain intensity, being higher in people with less education and physical dependency. The high frequency of both conditions in Chilean elderly people and their serious consequences make it an urgent public health problem, aggravated as a consequence of the prolonged isolation due to the COVID-19 pandemic.
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Depresión , Dolor , Humanos , Chile/epidemiología , Femenino , Masculino , Anciano , Estudios Transversales , Persona de Mediana Edad , Depresión/epidemiología , Dolor/epidemiología , Dolor/psicología , Anciano de 80 o más Años , Dimensión del Dolor , Factores de Riesgo , Factores Socioeconómicos , Índice de Severidad de la Enfermedad , Factores Sociodemográficos , Modelos LogísticosRESUMEN
Pain is a widespread and troubling clinical and social problem with important effects on society and individuals. The purpose is to assess the relationship between pain and eating behavior, macro-micronutrient intake, and dietary inflammation index. The study was carried with a total of 80 patients, consisting of 40 patients diagnosed with pain and 40 patients not diagnosed with pain, who applied to a private hospital in Istanbul as outpatients with a questionnaire face-to-face consisting of questions about sociodemographic characteristics, anthropometric measurements, pain-related information, Eating Attitude Test (EAT-19), and 24-hour food consumption record. The statistical analysis of the data was conducted with SPSS v27 package program. People who had pain had higher levels of disrupted eating attitudes than those who did not have pain. The "Bulimia" subfactor mean score of the EAT-19 was higher in those with pain (P < .05). No difference was found between the case-control groups regarding the mean dietary inflammation index (DII) score and energy, macro- and micronutrient consumption values (P > .05). No difference was detected between the case-control groups with disrupted eating attitudes regarding the median DII score (P > .05). The median DII score was significantly higher in individuals with pain and normal eating attitudes than in those without pain and with disrupted eating attitudes (P < .05). There is a relationship between pain, eating attitudes, and DII, the median DII score of those who had pain and had normal eating attitudes was higher.
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Conducta Alimentaria , Inflamación , Dolor , Humanos , Femenino , Masculino , Estudios de Casos y Controles , Adulto , Conducta Alimentaria/psicología , Dolor/epidemiología , Dolor/etiología , Persona de Mediana Edad , Turquía/epidemiología , Encuestas y Cuestionarios , Dieta , Adulto JovenRESUMEN
The social isolation imposed by the COVID-19 pandemic interrupted in-person activities, which were immediately followed by adaptations to ensure, for example, the continuity of teaching. This generated emotional impacts on the academic community. Emotional states may trigger or emphasize conditions such as temporomandibular dysfunction (TMD), causing pain and limiting masticatory function. This study aimed to compare the students and the faculty of a medical school first in terms of the TMD-caused pain they experienced during social isolation and reported two months later, according to their recollections, using the TMD-Pain Screener questionnaire. The second basis for comparison was the emotional state generated by social isolation and its connection with TMD symptoms assessed through the Depression, Anxiety and Stress Scale (DASS-21), which considers perceptions at the time of data collection. Both questionnaires were responded to in May 2022 after the end of social isolation. The data were analyzed by the IBM-SPSS software for Windows 22.0 with a 5% level of significance. The results show that the self-reported TMD symptoms were more widespread (p = 0.002) and intense (p = 0.013) among students than among faculty and that all of the former's DASS-21 domains (depression, anxiety, and stress) were also more strongly evident (p<0.05). Only anxiety was more significant among the faculty (p = 0.027). Both groups pointed to social isolation as an aggravating factor of the symptoms (p<0.05). The conclusion is that the self-reported TMD-caused pain and all DASS-21 domains as experienced during social isolation were stronger and more prevalent among students than among faculty, and that only anxiety was statistically significant among faculty. Also, the emotional states resulting from social isolation may have aggravated TMD-caused pain in both groups.
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COVID-19 , Emociones , Autoinforme , Aislamiento Social , Estudiantes de Medicina , Trastornos de la Articulación Temporomandibular , Humanos , COVID-19/psicología , COVID-19/epidemiología , Masculino , Femenino , Estudiantes de Medicina/psicología , Estudios Transversales , Trastornos de la Articulación Temporomandibular/psicología , Trastornos de la Articulación Temporomandibular/epidemiología , Adulto , Aislamiento Social/psicología , Encuestas y Cuestionarios , Adulto Joven , Ansiedad/epidemiología , Ansiedad/psicología , Facultades de Medicina , Pandemias , Dolor/psicología , Dolor/epidemiología , Depresión/epidemiología , Depresión/psicología , SARS-CoV-2/aislamiento & purificaciónRESUMEN
Oxidative stress has been identified as a major factor in the development and progression of pain and psychiatric disorders, but the underlying biomarkers and molecular signaling pathways remain unclear. This study aims to identify oxidative stress-related biomarkers and signaling pathways in pain-depression comorbidity. Integrated bioinformatics analyses were applied to identify key genes by comparing pain-depression comorbidity-related genes and oxidative stress-related genes. A total of 580 differentially expressed genes and 35 differentially expressed oxidative stress-related genes (DEOSGs) were identified. By using a weighted gene co-expression network analysis and a protein-protein interaction network, 43 key genes and 5 hub genes were screened out, respectively. DEOSGs were enriched in biological processes and signaling pathways related to oxidative stress and inflammation. The five hub genes, RNF24, MGAM, FOS, and TKT, were deemed potential diagnostic and prognostic markers for patients with pain-depression comorbidity. These genes may serve as valuable targets for further research and may aid in the development of early diagnosis, prevention strategies, and pharmacotherapy tools for this particular patient population.
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Biomarcadores , Comorbilidad , Biología Computacional , Depresión , Redes Reguladoras de Genes , Estrés Oxidativo , Dolor , Mapas de Interacción de Proteínas , Estrés Oxidativo/genética , Humanos , Biología Computacional/métodos , Dolor/genética , Dolor/epidemiología , Mapas de Interacción de Proteínas/genética , Depresión/genética , Depresión/epidemiología , Perfilación de la Expresión Génica , Transducción de Señal/genéticaRESUMEN
Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce.
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Enfermeras y Enfermeros , Rendimiento Laboral , Humanos , Estudios Transversales , Masculino , Adulto , Femenino , Estados Unidos/epidemiología , Persona de Mediana Edad , Encuestas y Cuestionarios , Rendimiento Laboral/normas , Rendimiento Laboral/estadística & datos numéricos , Enfermeras y Enfermeros/estadística & datos numéricos , Enfermeras y Enfermeros/psicología , Lugar de Trabajo/normas , Lugar de Trabajo/psicología , Lugar de Trabajo/estadística & datos numéricos , Dolor/epidemiologíaRESUMEN
Identifying depression symptoms in patients with hip fractures and studying the relationship between depression and pain intensity and pain location in hip fracture patients is of great significance for disease recovery in hip fracture patients. This cohort study analyzed 5 wave data from the China Health and Retirement Longitudinal Study in 2011, 2013, 2015, 2018, and 2020, focusing on 1222 patients with hip fractures. The study utilized the CESD-10 Depression Scale to assess depressive symptoms in hip fracture patients and conducted analyses to explore the relationship between depression symptoms, pain, and pain intensity, including binary logistic regression and examination of interaction terms between pain variables and pain intensity in key body parts. Depression symptoms are strongly associated with pain intensity in hip fracture patients, particularly in key body areas. Severe pain significantly increases the risk of depressive symptoms. Moreover, absence of pain in other key body parts is linked to depressive symptoms. Multivariate analysis reveals that higher education levels, marriage, urban residence, and self-rated good health serve as protective factors against depression, while diabetes and heart disease pose significant risks for depressive symptoms in hip fracture patients. Hip fracture pain can induce discomfort and trigger depressive symptoms, showing varied trajectories among patients. Pain intensity predicts the course of depressive symptoms, emphasizing the importance of tailored pain management strategies including medication, physical therapy, and nonpharmacological interventions. Personalized rehabilitation and mental health plans should be designed based on individual patient needs and differences.
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Depresión , Fracturas de Cadera , Dolor , Humanos , Fracturas de Cadera/psicología , Fracturas de Cadera/complicaciones , Fracturas de Cadera/epidemiología , Femenino , Masculino , Anciano , Depresión/epidemiología , Depresión/etiología , China/epidemiología , Dolor/psicología , Dolor/etiología , Dolor/epidemiología , Estudios Longitudinales , Persona de Mediana Edad , Dimensión del Dolor , Anciano de 80 o más Años , Factores de RiesgoRESUMEN
Hip pain is a prevalent degenerative joint symptoms, imposing a significant global health burden. Hip pain is experiencing an increase in incidences in Korea due to its aging society, and the social burden of hip pain continues to rise as the hip joint is crucial for gait and balance. This study assessed the epidemiology of hip pain in Korea using data from the fifth version of Korea National Health and Nutrition Examination Survey (KNHANES V-5). The research analyzed data from 8,898,044 Koreans to evaluate the prevalence and characteristics of hip pain and abnormal hip X-ray. Variables encompassed medical, demographic, mental, social, and musculoskeletal factors. Descriptive analysis and propensity score matching analyses unveiled characteristics of Koreans experiencing hip pain or showing abnormal hip x-ray. The study provides insights into the epidemiology of hip pain in the entire Korean population, and further suggesting the effective management of hip pain.
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Articulación de la Cadera , Humanos , República de Corea/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Articulación de la Cadera/diagnóstico por imagen , Anciano , Prevalencia , Radiografía , Encuestas Nutricionales , Artralgia/epidemiología , Dolor/epidemiología , Adulto Joven , Estudios Epidemiológicos , Pueblos del Este de AsiaRESUMEN
This cohort study assesses the association of pain phenotypes and pain multimorbidity with cerebral palsy subtypes among Medicare beneficiaries.
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Parálisis Cerebral , Medicare , Multimorbilidad , Dolor , Fenotipo , Humanos , Estados Unidos/epidemiología , Parálisis Cerebral/epidemiología , Masculino , Femenino , Dolor/epidemiología , Anciano , Persona de Mediana EdadRESUMEN
PURPOSE: Pain is a common symptom following proximal femoral fractures (PFF), however, information on its treatment in terms of agents and type of use (scheduled vs. pro re nata [PRN]) is scarce. The main objective of this study was to examine pain medication regimens according to pain intensity following PFF. Furthermore, we explored the utilization of medication plans. METHODS: The "ProFem"-study on healthcare provision, functional ability, and quality of life after PFF is a German population-based prospective cohort study based on statutory health insurance data and individually linked survey data from different time points including information on the currently used medication. This present analysis refers to the participants' baseline interviews (about 3 months following PFF) conducted from 2018 to 2019 in the participants' private surroundings. RESULTS: The study population comprised 444 participants (mean age: 81.2 years, 71.0% female). Half of them reported high intensity pain, and the mean value for the EuroQol visual analogue scale was 50.8. Most commonly used analgesics were metamizole and tilidine/naloxone. Among participants with high intensity pain, 21.9% received only PRN pain medication and 17.2% no pain medication at all. Overall, 61.5% of participants presented any (printed) medication plan and only 25.2% a "federal standardized medication plan" (BMP). CONCLUSION: As a substantial number of patients reports high intensity pain about 3 months following a PFF, the large proportion of those receiving no or only PRN pain medication raises questions regarding the appropriateness of the therapy. The overall low utilization of the BMP indicates potential for improvement.
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Analgésicos , Fracturas de Cadera , Dimensión del Dolor , Dolor , Humanos , Femenino , Fracturas de Cadera/epidemiología , Masculino , Anciano , Estudios Prospectivos , Anciano de 80 o más Años , Analgésicos/uso terapéutico , Analgésicos/administración & dosificación , Dolor/tratamiento farmacológico , Dolor/etiología , Dolor/epidemiología , Alemania/epidemiología , Calidad de Vida , Estudios de CohortesRESUMEN
BACKGROUND: Pain is a dynamic experience that varies over time, but it remains unknown whether trajectories of pain are associated with subsequent cognitive decline. The purpose of this study was to identify distinct trajectories of pain presence and activity-limiting pain and investigate their longitudinal associations with the rate of subsequent cognitive decline in older adults. METHODS: A total of 5685 participants from the English Longitudinal Study of Ageing (ELSA) and 7619 participants from the Health and Retirement Study (HRS) were included. Pain presence trajectories were identified over eight years in the ELSA and 10 years in the HRS, while trajectories of activity-limiting pain were identified over 10 years in the HRS. We utilised linear mixed-effects models to investigate the long-term relationship between pain trajectories and the rate of cognitive decline across various domains, including memory, orientation, executive function and global cognition. RESULTS: Three pain presence trajectories were identified. Moderate-increasing and high-stable groups exhibited steeper declines in global cognition than the low-stable group. Furthermore, individuals in the moderate-increasing group experienced a more rapid decline in executive function, while the high-stable group showed a faster decline in orientation function. Two trajectories of activity-limiting pain were identified, with the moderate-increasing group experiencing a faster decline in orientation function and global cognition. CONCLUSIONS: The trajectories of both pain presence and activity-limiting pain are linked to the rate of subsequent cognitive decline among older people. Interventions for specific pain trajectories might help to delay the decline rate of cognition in specific domains.
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Disfunción Cognitiva , Dolor , Humanos , Anciano , Masculino , Femenino , Estudios Longitudinales , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/psicología , Disfunción Cognitiva/diagnóstico , Dolor/psicología , Dolor/diagnóstico , Dolor/epidemiología , Cognición , Anciano de 80 o más Años , Persona de Mediana Edad , Factores de Tiempo , Envejecimiento/psicología , Función Ejecutiva , Factores de Riesgo , Inglaterra/epidemiología , Factores de EdadRESUMEN
OBJECTIVE: Identify factors associated with persistent sexual dysfunction and pain 12-months postpartum in an underserved population. METHODS: Extending Maternal Care After Pregnancy (eMCAP) is a program addressing health needs/disparities of patients at risk for worse perinatal outcomes. Participants completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Urinary Distress Index (UDI-6) 12-months postpartum. The PISQ-12 was dichotomized with scores < 32.5 indicating sexual dysfunction. Urinary incontinence (UI) was defined as at-least-somewhat bothersome (vs. none or not-at-all bothersome) urgency urinary incontinence (UUI) or stress urinary incontinence (SUI). Screening for anxiety and depression was completed using Generalized Anxiety Disorder-7 (GAD-7) and Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariable logistic regression analyses were performed for sexual dysfunction vs. normal-function, and pain vs. no-pain, using demographic, peri/postpartum, and social-determinant-of-health variables as correlating factors. RESULTS: 328 sexually active patients provided data. On bivariate analysis, sexual dysfunction (n = 31, 9.5%) vs. normal function (n = 297, 90.5%) groups showed no differences in age, BMI, parity, mode of delivery, episiotomy/laceration types, or breastfeeding. Sexual dysfunction was significantly associatedwith both UUI and SUI: 12 (39%) vs. 46 (15%) had UUI, p = 0.001, and 20 (65%) vs. 97 (33%) had SUI, P < 0.001; the dysfunction group also had higher GAD-7 and EPDS scores and greater overall stress levels. On multivariable analysis, SUI and stress remained significantly associated: OR (95% CI) 2.45 (1.02-6.03) and 1.81 (1.32-2.49), respectively. Comparing pain (n = 45, 13.7%) vs. no-pain (n = 283, 86.2%), dyspareunia patients endorsed greater stress levels. CONCLUSION: The interplay between sexual health, incontinence, and mental health deserves further study, and all three should be routinely addressed in postpartum care.
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Periodo Posparto , Disfunciones Sexuales Fisiológicas , Humanos , Femenino , Adulto , Disfunciones Sexuales Fisiológicas/epidemiología , Disfunciones Sexuales Fisiológicas/etiología , Encuestas y Cuestionarios , Embarazo , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/complicaciones , Ansiedad/epidemiología , Disfunciones Sexuales Psicológicas/epidemiología , Disfunciones Sexuales Psicológicas/etiología , Dispareunia/epidemiología , Dispareunia/etiología , Factores de Riesgo , Incontinencia Urinaria de Esfuerzo/epidemiología , Prolapso de Órgano Pélvico/epidemiología , Prolapso de Órgano Pélvico/complicaciones , Dolor/epidemiología , Depresión Posparto/epidemiología , Adulto Joven , Depresión/epidemiologíaRESUMEN
Pain recognition for culturally diverse people is complex as pain experience is subjective and influenced by cultural background. We compared the prevalence, intensity, and association of pain with neuropsychiatric symptoms (NPS) between immigrants and non-immigrants living with dementia in residential aged care homes (RACHs) who were referred to two Dementia Support Australia programs. Immigrant status was defined by the documented country of birth. Pain and NPS were assessed using PainChek® and the Neuropsychiatric Inventory, respectively. Subgroup analyses were also completed for English-speaking and non-English-speaking immigrants. A total of 17,637 referrals [immigrants, n = 6340; non-immigrants, n = 11,297] from 2792 RACHs were included. There were no significant differences for the prevalence of pain across all groups. Immigrants were slightly more likely to have moderate pain or severe pain than non-immigrants. Non-English-speaking immigrants had 0.5 points higher total pain scores on average (Cohen's d = 0.10 [0.05, 0.15], p < 0.001) than non-immigrants. Total pain score had a significant effect on total NPS severity scores in all groups. While pain prevalence is similar across groups, higher pain intensities are more common among immigrants living with dementia. Increased care staff awareness, education, and training about the potential effect of culture on pain expression is needed.
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Demencia , Emigrantes e Inmigrantes , Dolor , Humanos , Demencia/epidemiología , Femenino , Masculino , Australia/epidemiología , Emigrantes e Inmigrantes/psicología , Emigrantes e Inmigrantes/estadística & datos numéricos , Prevalencia , Anciano , Anciano de 80 o más Años , Dolor/epidemiología , Hogares para Ancianos/estadística & datos numéricos , Dimensión del DolorRESUMEN
BACKGROUND: Intensive care unit (ICU) patients experience several symptoms, yet patterns of symptoms and their relationship with demographic and clinical characteristics have not previously been investigated. OBJECTIVES: To identify and compare subgroups (i.e. latent symptom classes) of intensive ICU patients based on prevalence of co-occurring symptoms over seven days. RESEARCH METHODOLOGY: Prospective cohort study of adult ICU patients' self-reports of five symptoms during seven days in ICU. Latent class analysis was applied to identify subgroups of ICU patients. SETTING: Multicenter study with patients from six mixed ICUs in Norway. MAIN OUTCOME MEASURES: Patient Symptom Survey was used to assess five symptoms (i.e., thirst, pain, anxiousness, tiredness, shortness of breath). RESULTS: Among 353 included patients, median age was 63 years and 60.3 % were male. Subgroups of patients were identified in a Low class (n = 126, 35.7 %), Middle Class (n = 177, 50.1 %) and High Class (n = 50, 14.2 %) based on reporting of the prevalence of five symptoms. Patients in the Low class had a low prevalence of all symptoms. Middle Class patients had a high prevalence of thirst and tiredness and a low prevalence of pain, anxiousness and shortness of breath. The High class patients had a high prevalence of all symptoms. Symptom prevalence remained stable in the Low and Middle class over time and increased over time in the High class. There were significant differences among symptom classes in use of mechanical ventilation (p = 0.012), analgesics (p < 0.001), alpha-2 agonists (p = 0.004) and fluid restriction (p = 0.006). Patients in the High class received more of these ICU-treatments. CONCLUSIONS: Findings suggest that subgroups of ICU patients with distinct symptom experiences can be identified. The High prevalence class patients had consistently high levels of all symptoms across seven ICU days and received more ICU-related interventions. IMPLICATION FOR CLINICAL PRACTICE: Some ICU patients experience a consistently high prevalence of co-occurring symptoms. Clinicians should be aware of treatment factors that could be linked to a high burden of symptoms.
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Unidades de Cuidados Intensivos , Autoinforme , Humanos , Masculino , Femenino , Estudios Prospectivos , Persona de Mediana Edad , Unidades de Cuidados Intensivos/organización & administración , Unidades de Cuidados Intensivos/estadística & datos numéricos , Noruega/epidemiología , Anciano , Prevalencia , Ansiedad/epidemiología , Ansiedad/psicología , Estudios de Cohortes , Dolor/etiología , Dolor/epidemiología , Sed/fisiología , Encuestas y Cuestionarios , Adulto , Disnea/etiología , Fatiga/etiología , Fatiga/epidemiologíaRESUMEN
The population of people in federal custody in Canada is aging. Those in custody report experiencing poorer health and high rates of chronic health conditions. Two health concerns that are disproportionately higher among those in custody are mood disorders and pain. This cross-sectional study examined health indicators associated with pain and depressive symptoms among older people (50 years and above) from multiple facilities and security levels in federal custody in Canada. Participants were assessed using the interRAI Emergency Department Contact Assessment, which captures key health indicators. Chi square and logistic regression analyses were conducted to describe the population and identify health indicators associated with mood- and pain-related outcomes, respectively. Of the 1,422 participants in this study, the majority (55%) experienced pain and at least 1 out of 5 experienced depressive symptoms. Health indicators associated with depressive symptoms and/or pain were functional measures, including mobility, managing medication(s), and dyspnea. Depressive symptoms and pain are highly prevalent among older adults in federal custody. The relationship between functional health, depressive symptoms, and pain highlights the importance of interprofessional health care and biopsychosocial intervention(s).
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Depresión , Dolor , Humanos , Masculino , Femenino , Estudios Transversales , Anciano , Persona de Mediana Edad , Depresión/epidemiología , Dolor/epidemiología , Canadá/epidemiología , Trastornos del Humor/epidemiología , Prisioneros/psicología , Prisioneros/estadística & datos numéricos , Anciano de 80 o más Años , Estado de SaludRESUMEN
OBJECTIVE: To determine the incidence of patients presenting in pain to a large Australian inner-city emergency department (ED) using a clinical text deep learning algorithm. MATERIALS AND METHODS: A fine-tuned, domain-specific, transformer-based clinical text deep learning model was used to interpret free-text nursing assessments in the electronic medical records of 235,789 adult presentations to the ED over a three-year period. The model classified presentations according to whether the patient had pain on arrival at the ED. Interrupted time series analysis was used to determine the incidence of pain in patients on arrival over time. We described the changes in the population characteristics and incidence of patients with pain on arrival occurring with the start of the Covid-19 pandemic. RESULTS: 55.16% (95%CI 54.95%-55.36%) of all patients presenting to this ED had pain on arrival. There were differences in demographics and arrival and departure patterns between patients with and without pain. The Covid-19 pandemic initially precipitated a decrease followed by a sharp, sustained rise in pain on arrival, with concurrent changes to the population arriving in pain and their treatment. DISCUSSION: Applying a clinical text deep learning model has successfully identified the incidence of pain on arrival. It represents an automated, reproducible mechanism to identify pain from routinely collected medical records. The description of this population and their treatment forms the basis of intervention to improve care for patients with pain. The combination of the clinical text deep learning models and interrupted time series analysis has reported on the effects of the Covid-19 pandemic on pain care in the ED, outlining a methodology to assess the impact of significant events or interventions on pain care in the ED. CONCLUSION: Applying a novel deep learning approach to identifying pain guides methodological approaches to evaluating pain care interventions in the ED, giving previously unavailable population-level insights.
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COVID-19 , Aprendizaje Profundo , Servicio de Urgencia en Hospital , Dolor , Humanos , Servicio de Urgencia en Hospital/estadística & datos numéricos , COVID-19/epidemiología , Masculino , Femenino , Dolor/epidemiología , Dolor/diagnóstico , Persona de Mediana Edad , Adulto , Registros Electrónicos de Salud/estadística & datos numéricos , Análisis de Series de Tiempo Interrumpido , Anciano , Australia/epidemiología , Incidencia , SARS-CoV-2RESUMEN
OBJECTIVE: Adverse childhood experiences (ACEs) have been associated with a range of adverse health outcomes, with pain being potentially one of them. This population-based cross-sectional study aimed to investigate the associations between Adverse Childhood Experiences (ACEs) and pain in Chinese adults and evaluate whether physical activity and demographic and socioeconomic characteristics modify this associations. METHODS: Cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS), were utilized in this study. A total of 9923 respondents with information on 12 ACE indicators and 15 self-reported body pains were included. Logistic regression models were used to assess associations of the ACEs and pain. Modification of the associations by physical activity, demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction. RESULTS: Among the 9923 individuals included in the primary analyses, 5098 (51.4%) males and the mean (SD) age was 61.18 (10·.44) years. Compared with individuals with 0 ACEs, those who with ≥ 5 ACEs had increased risk of single pains and multiple pain. A dose-response association was found between the number of ACEs and the risk of pain (e.g. neck pain for ≥ 5 ACEs vs. none: OR, 1.107; 95% CI, 0.903-1.356; p < 0.001 for trend). In the associations of each body pain with each ACE indicator, most ACE indicators were associated with an increased risk of pain. In addition, physical activity, sociodemographic and socioeconomic characteristics, such as age, sex, educational level, area of residence, childhood economic hardship, did not demonstrate a significant modify on the associations between ACEs and pain. CONCLUSIONS: These findings indicate that cumulative ACE exposure is associated with increased odds of self-reported pain in Chinese adults, regardless of adult physical activity, sociodemographic and socioeconomic characteristics.
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Experiencias Adversas de la Infancia , Dolor , Humanos , Masculino , Femenino , China/epidemiología , Estudios Longitudinales , Experiencias Adversas de la Infancia/estadística & datos numéricos , Persona de Mediana Edad , Estudios Transversales , Anciano , Dolor/epidemiología , Ejercicio Físico , Factores Socioeconómicos , Factores de RiesgoRESUMEN
OBJECTIVE: To determine the frequency and pattern of different aetiologies of leg pain among patients visiting vascular surgery clinics. STUDY DESIGN: Cross-sectional study. Place and Duration of the Study: Vascular Surgery Clinics of the Aga Khan University Hospital, Karachi, Pakistan, between February 2021 and June 2023. METHODOLOGY: This study examined patients presenting with leg pain for the first time at vascular surgery clinics. The socio-demographic and clinical data including the clinical symptoms, physical examination findings, and management of leg pain were noted using a specially designed proforma. RESULTS: In a total of 142 patients (200 limbs), 82 (57.7%) were females and 60 (42.3%) were males, with a mean age of 46.8 ± 15.1 years. The patients' mean body mass index (BMI) was 30.2 ± 7.9 kg/m2. Ninety-one (64.1%) patients had a predominantly standing job compared to 51 (35.9%) patients who had a predominantly sitting job. The most common aetiology of leg pain was chronic venous insufficiency (CVI), diagnosed in 107 (53.5%) patients, followed by neurogenic pain [41 (20.5%)], musculoskeletal pain including knee osteoarthritis [30 (15.0%)], and arterial insufficiency [22 (11.0%)]. Conclusion: CVI followed by neuropathic pain was the leading cause of leg pain in vascular surgery clinics at a tertiary care hospital. KEY WORDS: Chronic venous insufficiency, Arterial insufficiency, Vascular surgery, Leg pain, Musculoskeletal pain, Neuralgia.
Asunto(s)
Pierna , Humanos , Femenino , Masculino , Persona de Mediana Edad , Estudios Transversales , Pakistán/epidemiología , Adulto , Pierna/irrigación sanguínea , Procedimientos Quirúrgicos Vasculares , Dolor/etiología , Dolor/epidemiología , Neuralgia/etiología , Neuralgia/epidemiología , Anciano , Dolor Musculoesquelético/epidemiología , Dolor Musculoesquelético/etiologíaRESUMEN
OBJECTIVE: The association of physical activity (PA) with pain has been characterized. Although the literature largely comes from high-income countries, the mechanistic pathways underlying this association remain unknown, particularly in low- and middle-income countries (LMICs). We aim to examine the association between meeting the World Health Organization (WHO) PA guidelines and pain among aging adults and identify the factors that may mediate this association. DESIGN: We used a quantitative cross-sectional study design. SETTING AND PARTICIPANTS: Representative data from adults aged ≥50 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study were used. METHODS: PA was defined using the International Physical Activity Questionnaire (IPAQ). Self-reported pain experience using a cross-culturally validated item over the past month assessed pain severity. Adjusted multivariable ordinal logistic regression and mediation models quantified the hypothesized associations. RESULTS: The analysis included 1201 adults (mean 66.1 ± 11.9 years; 63.3% female). After adjusting for confounders, adhering to the WHO-recommended PA guidelines was associated with 42% lower odds for severe/extreme pain [odds ratio (OR) 0.58, 95% CI 0.44-0.77]. The association was much stronger among men (OR 0.52, 95% CI 0.31-0.85) than women (OR 0.60, 95% CI 0.42-0.87). The PA-pain association was explained by functional limitations (84.7%), self-rated health (76.6%), sleep problems (20.4%), and injury (6.6%). CONCLUSIONS AND IMPLICATIONS: Moving more was associated with less pain in older adults from LMICs. Interventions for pain management in old age may focus on enhancing compliance with PA doses, particularly in LMICs. However, longitudinal data will need to confirm these findings.
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Ejercicio Físico , Dolor , Humanos , Masculino , Femenino , Anciano , Estudios Transversales , Ghana , Persona de Mediana Edad , Dolor/epidemiología , Envejecimiento/fisiología , Encuestas y Cuestionarios , Dimensión del DolorRESUMEN
This study explored the relationship between variables emphasized in the theory's first step of the three-step theory (3ST)-psychache, hopelessness, and their interaction-to suicide-related variables (i.e., lifetime suicidal ideation and attempt, past-year suicidal ideation, communication of suicidal thoughts, and self-reported future suicide attempt likelihood). Chinese undergraduate students (N = 11,399; mean age = 20.69 ± 1.35) from seven provinces participated in this cross-sectional survey. They answered the Suicidal Behaviors Questionnaire-Revised, Psychache Scale, and Beck Hopelessness Scale. Bivariate and multivariate analyses were used to examine the association between psychache, hopelessness, and hopelessness × psychache interaction on the outcome variables. Bivariate analyses showed that psychache and hopelessness were correlated with suicidal ideation and behaviors. In multiple regression models, the interaction between psychache and hopelessness was significantly associated with past-year suicidal ideation and self-report chances of a future suicide attempt, p < 0.001, though effect sizes for the interaction term were small. The results are broadly consistent with the 3ST's proposition of how the combination of pain and hopelessness is related to various suicide-related variables. The low prevalence of suicide-related communication should inform future suicide prevention measures by encouraging help-seeking. Psychache as a correlate of the self-reported likelihood of a future attempt could be further investigated.