Pain correlates with social integration in individuals with traumatic spinal cord injury: A cross-sectional survey
Wang Dawu, He Chao, Li Kaiting, Shao Lan, Peng Xiaohua, Bai Dingqun
Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, China.
Objective: To describe the relationship between pain and social integration following spinal cord injury using comprehensive evaluation of pain-related clinical characteristics and different aspects of social integration.
Design: A cross-sectional study.
Participants: A total of 318 participants with American Spinal Cord Injury Association Impairment Scale (AIS) Grades A, B, C or D and > 3 months post-injury.
Methods: All participants completed the survey relating to demographics, pain characteristics, and the Craig Handicap Assessment Reporting Technique Social Integration scores.
Results: Individuals who were younger, those 3–6 years after injury, and those with a grade of AIS grade A (odds ratio (OR) 8.32, 95% confidence interval (95% CI) 1.83–12.07) or B (OR 3.25, 95% CI 0.91–7.63) were more likely to report neuropathic pain. Significant inverse correlations were found between pain intensity and social integration (R = –0.597, p = 0.019). Brief Pain Inventory interference scores were negatively associated with 5 (friends, living situation, business, strangers and family) of 6 domains of Craig Handicap Assessment Reporting Technique social integration (p < 0.001). Pain type and only 1 domain (strangers) showed a significant negative relationship (B=–1.47, p = 0.02).
Conclusion: Chronic pain after spinal cord injury is negatively associated with Craig Handicap Assessment Reporting Technique social integration. Brief Pain Inventory Pain interference, to a greater extent than pain type, best predicts social integration after spinal cord injury.
After spinal cord injury, pain is a common and sometimes severe complication. Social integration has been linked to positive outcomes including better physical health. This study aimed at exploring the association between pain and social integration post-spinal cord injury. Our results showed that those with neuropathic pain presented more severe pain. The presence of pain negatively impacted social integration post injury. Pain interference was the best pain item to predict social integration in those who reported pain.
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