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- Prego-Domínguez, Jesús, et al.
(författare)
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Social factors and chronic pain : The modifying effect of sex in the Stockholm Public Health Cohort Study
- 2022
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Ingår i: Rheumatology. - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 61:5, s. 1802-1809
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess the relation between social factors (socioeconomic status, household load and job strain) and chronic pain occurrence, and the role of gender in this relation.METHODS: We used data corresponding to 8 years of follow-up of the Stockholm Public Health Cohort Study (2006 to 2014) to compute Adjusted Incidence Rate Ratios (IRR) and additive interaction measures of chronic pain episodes, social factors, and sex in 16,687 subjects.RESULTS: For men, increased rates were observed for skilled workers (IRR=1.27, 95% Confidence Interval (CI): 0.99, 1.61) and lower non-manual employees (IRR=1.37, 95%CI: 1.05, 1.78), compared to unskilled workers; subjects with high household load (IRR=1.39; 95%CI: 1.03, 1.88), compared to those with null score; and active jobs (IRR=1.27, 95%CI: 1.06, 1.51), compared to low strain jobs. For women, we observed decreased rates for lower (IRR=0.82, 95%CI: 0.68, 0.99), intermediate (IRR=0.74, 95%CI: 0.63, 0.88) and higher non-manual employees (IRR=0.65, 95%CI: 0.54, 0.79), compared to unskilled workers. Compared to subjects with a null score, women with low household load showed a lower rate (IRR=0.85; 95%CI: 0.72, 1.00). Compared to low strain jobs, passive jobs (IRR=1.21; 95%CI: 1.02, 1.44) and high strain jobs (IRR=1.46; 95%CI: 1.02, 2.09) showed higher rates.CONCLUSION: In general, our analysis yielded different results, if not opposite, when data were stratified by sex. Sex may then represent an effect modifier of the relation between social factors and chronic pain.RHEUMATOLOGY KEY MESSAGES: Low socioeconomic status and high job strain household load are related to chronic pain occurrence.Sex is an effect modifier of the relation between socioeconomic status and chronic pain; that is, this relation is different between men and women.
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| 2. |
- Prego-Domínguez, Jesús, et al.
(författare)
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Social factors and pain worsening : A retrospective cohort study
- 2021
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Ingår i: British Journal of Anaesthesia. - : Elsevier BV. - 0007-0912 .- 1471-6771. ; 127:2, s. 289-295
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Pain, specifically chronic pain, is a major public health issue worldwide with considerable health-related consequences and large economic impact. The relation between socioeconomic status and pain occurrence is well established. However, little is known on the relation between socioeconomic factors and worsening of pain, including progression from non-chronic pain to chronic pain.METHODS: To assess the relation between socioeconomic status and pain worsening, we used the Stockholm Public Health Cohort Study from 2006 to 2014 and analysed data of 9721 participants who completed follow-up. The adjusted incidence rate ratios (IRRs) of moderate and severe pain worsening episodes were computed, using a pain amplification model, which encompasses spreading, somatisation, and psychological distress components. Multiple imputation analysis was performed subsequently to adjust for cohort attrition.RESULTS: Compared with non-skilled workers, self-employed subjects (IRR=1.18; 95% confidence interval [CI], 1.01-1.39) and non-manual employees were at higher risk of moderate worsening (lower non-manual employees: IRR=1.21; 95% CI, 1.03-1.41; intermediate non-manual employees: IRR=1.26; 95% CI, 1.10-1.44; higher non-manual employees: IRR=1.25; 95% CI, 1.08-1.45). This risk increase was limited to worsening starting at stage 0 (non-chronic pain). No association was found between socioeconomic status and severe pain worsening.CONCLUSION: Our results support a moderate association between intermediate and high socioeconomic status, and moderate pain worsening. This association could be explained by the heterogeneous composition of the socioeconomic variable used in this cohort, and by changes in exposure and other time-varying covariables' status during follow-up.
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