Do Psychological Factors Explain the Persistence of Symptoms in Individuals with Rotator Cuff-related Shoulder Pain? A Prospective Cohort Study.

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

Clinical Journal of Pain Pub Date : 2025-03-10 DOI:10.1097/AJP.0000000000001280

Dayana Patricia Rosa, Marc-Olivier Dubé, Simon Beaulieu-Bonneau, Alex Scott, Hugo Masse-Alarie, Jean-Sébastien Roy

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引用次数: 0

Abstract

Objective: To determine whether psychosocial factors such as resilience, perceived stress, catastrophizing, anxiety, depression, pain self-efficacy, and social support, explain the persistence of pain and disability in individuals with RCRSP following an education program.

Methods: One hundred forty-three individuals with persistent RCRSP were included in this prospective cohort study. At baseline, participants completed self-reported questionnaires related to pain, disability, and psychosocial constructs, including resilience, stress, catastrophizing, anxiety and depressive symptoms, pain self-efficacy, and social support. Thereafter, participants took part in an educational program aimed at promoting self-management of RCRSP that included two meetings with a physiotherapist. After 12 and 24-weeks, participants filled only pain and disability questionnaires and based on their scores, were classified as having persistent shoulder pain or as recovered.

Results: A univariable modified Poisson regression showed that higher perceived stress (RRadjusted: 1.02; 95%CI: 1.01-1.04), catastrophizing (RRadjusted: 1.01; 95%CI: 1.01-1.02), symptoms of depression (RRadjusted: 1.03; 95%CI: 1.01-1.06) and anxiety (RRadjusted: 1.03; 95%CI: 1.01-1.06), along with lower resilience (RRadjusted: 0.90; 95%CI: 0.81-1.00), were associated with ongoing RCRSP at 12 weeks. Additionally, reduced pain self-efficacy was associated with persistent pain at both 12 weeks (RRadjusted: 0.98; 95%CI: 0.97-0.99) and 24 weeks (RRadjusted: 0.99; 95%CI: 0.98-1.00). Multivariable regression indicated that only pain self-efficacy served as a protective factor against persistent RCRSP (RRadjusted: 0.98; 95%CI: 0.97-0.99).

Discussion: This study sheds light on the impact of psychosocial factors on persistent RCRSP, underscoring the importance of positive beliefs in pain management. Importantly, pain self-efficacy emerges as a key factor in recovery.

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心理因素能解释肩袖相关性肩痛患者症状的持续存在吗？前瞻性队列研究。

目的：确定心理社会因素，如恢复力、感知压力、灾难化、焦虑、抑郁、疼痛自我效能和社会支持，是否可以解释RCRSP患者在接受教育后的疼痛和残疾的持续存在。方法：本前瞻性队列研究纳入143例持续性RCRSP患者。在基线时，参与者完成了与疼痛、残疾和心理社会结构相关的自我报告问卷，包括恢复力、压力、灾难化、焦虑和抑郁症状、疼痛自我效能和社会支持。之后，参与者参加了一个旨在促进RCRSP自我管理的教育项目，其中包括与物理治疗师的两次会面。12周和24周后，参与者只填写疼痛和残疾问卷，并根据他们的得分，将其分为持续性肩痛或康复。结果：单变量修正泊松回归结果显示，大学生的感知压力较高(RRadjusted: 1.02；95%CI: 1.01-1.04)、灾难化(调整后：1.01；95%CI: 1.01-1.02)，抑郁症状(rrrr调整：1.03；95%CI: 1.01-1.06)和焦虑(rrrr调整：1.03；95%CI: 1.01-1.06)，以及较低的恢复力(调整后rrr: 0.90；95%CI: 0.81-1.00)，与12周时持续RCRSP相关。此外，疼痛自我效能降低与12周的持续疼痛相关(rrrr调整：0.98；95%CI: 0.97-0.99)和24周(rrrr调整：0.99；95%置信区间:0.98—-1.00)。多变量回归表明，只有疼痛自我效能感是预防持续性RCRSP的保护因素(rr调整：0.98；95%置信区间:0.97—-0.99)。讨论：本研究揭示了社会心理因素对持续性RCRSP的影响，强调了积极信念在疼痛管理中的重要性。重要的是，疼痛自我效能是康复的关键因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Journal of Pain 医学-临床神经学

CiteScore

5.40

自引率

3.40%

发文量

118

审稿时长

4-8 weeks

期刊介绍： The Clinical Journal of Pain explores all aspects of pain and its effective treatment, bringing readers the insights of leading anesthesiologists, surgeons, internists, neurologists, orthopedists, psychiatrists and psychologists, clinical pharmacologists, and rehabilitation medicine specialists. This peer-reviewed journal presents timely and thought-provoking articles on clinical dilemmas in pain management; valuable diagnostic procedures; promising new pharmacological, surgical, and other therapeutic modalities; psychosocial dimensions of pain; and ethical issues of concern to all medical professionals. The journal also publishes Special Topic issues on subjects of particular relevance to the practice of pain medicine.