老年疼痛患者心理社会表型的转变。

IF 4 2区 医学 Q1 CLINICAL NEUROLOGY
Ashleigh Holmes PhD, MSN, RN, AGPCNP-BC , Yu-Ping Chang PhD, RN, FGSA, FIAAN, FAAN
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引用次数: 0

摘要

尽管疼痛在老年人中很普遍,但现有文献中关于疼痛结果的多变量心理社会因素的研究存在空白。确定心理社会表型,或心理和社会特征模式,有助于预测结果;然而,需要进一步的纵向分析。本研究探讨了老年疼痛患者心理社会表型的纵向稳定性,以及表型随时间变化的预测因子。根据2018-2022年年度国家健康和老龄化趋势研究数据,813名老年人持续报告疼痛。分析中使用的社会心理变量包括抑郁、焦虑、情感、自我实现、恢复力、自我效能和社会参与。潜在转变分析用于确定最佳的社会心理表型和纵向过渡到不同表型的参与者的比例。通过逻辑回归确定与心理社会表型纵向转变相关的基线变量(疼痛特征、身体、认知)。基于社会心理变量的得分,潜在转化分析得出了三种社会心理表型(不利、有利和中间)。纵向上,表型成员总体上保持稳定,并有增加社会心理逆境的趋势。基线认知和身体表现是纵向向较少不良表型过渡的预测因子。相比之下,基线睡眠、身体表现、疼痛限制和一般健康的自我评价是向更不利表型过渡的预测因子。有稳定的心理社会健康纵向老年人疼痛和显著的能力反弹,尽管主要的压力源。未来的研究应该探索促进向更有利的社会心理表型转变的干预措施,发展护理点临床见解,并推进精准疼痛医学。视角:本研究使用潜在转化分析分析了老年慢性疼痛患者的社会心理表型。它确定了稳定的表型(不利、中等、有利),并追踪了随时间的变化。研究结果强调了认知和身体健康对社会心理健康的影响,支持个性化干预和推进老年人的精准疼痛医学。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transitions in psychosocial phenotypes in older adults with pain
Although pain is prevalent in older adults, there are gaps in the existing literature regarding multivariable psychosocial contributors to pain outcomes. Identifying psychosocial phenotypes, or patterns of psychological and social characteristics, can help predict outcomes; however, further longitudinal analysis is required. This study explores the stability of psychosocial phenotypes longitudinally in older adults with pain, along with the predictors of transitions in phenotypes over time. Using 2018–2022 annual National Health and Aging Trends Study data, 813 older adults consistently reported pain. Psychosocial variables used in the analysis included depression, anxiety, affect, self-realization, resilience, self-efficacy, and social participation. Latent transition analysis was used to identify optimal psychosocial phenotypes and proportions of participants transitioning to different phenotypes longitudinally. Baseline variables (pain characteristics, physical, cognitive) associated with longitudinal transitions in psychosocial phenotypes were determined via logistic regression. Latent transition analysis resulted in three psychosocial phenotypes (Adverse, Favorable, and Intermediate) based on scores on psychosocial variables. Longitudinally, phenotype membership remained generally stable with a trend towards increased psychosocial adversity. Baseline cognition and physical performance were predictors of transitions to less adverse phenotypes longitudinally. In contrast, baseline sleep, physical performance, pain limitations, and self-rating of general health were predictors of transitions to more adverse phenotypes. There is stability in psychosocial well-being longitudinally in older adults with pain and a remarkable ability to rebound despite major stressors. Future research should explore interventions that promote transitions to more favorable psychosocial phenotypes, develop point-of-care clinical insights, and advance precision pain medicine.

Perspective

This study analyzed psychosocial phenotypes in older adults with chronic pain using latent transition analysis. It identified stable phenotypes (Adverse, Intermediate, Favorable) and tracked changes over time. Findings highlight the impact of cognitive and physical health on psychosocial well-being, supporting personalized interventions and advancing precision pain medicine in older adults.
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来源期刊
Journal of Pain
Journal of Pain 医学-临床神经学
CiteScore
6.30
自引率
7.50%
发文量
441
审稿时长
42 days
期刊介绍: The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.
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