类风湿关节炎疼痛对疲乏的影响:负性情绪和失眠的多重中介作用

Effects of pain on fatigue in patients with rheumatoid arthritis:multiple mediating effects of negative emotions and insomnia

目的了解类风湿关节炎患者疼痛、负性情绪(焦虑和抑郁)和失眠与疲乏症状的关系,探究负性情绪和失眠在疼痛和疲乏之间的多重中介作用。方法2018年10月至2019年1月选取北部战区总医院门诊的240例类风湿关节炎患者,使用一般情况调查表、Bristol类风湿关节炎患者疲劳多维问卷、视觉模拟量表、医院焦虑抑郁量表和阿森斯失眠量表分别评估患者的一般情况、疲乏、疼痛、焦虑、抑郁和失眠,使用SPSS 20.0软件进行相关分析,使用Mplus 7.0进行多重中介效应分析。结果类风湿关节炎患者疲乏得分为(28.88±14.89)分,疼痛得分4(2~7)分,失眠得分7(3~11)分,焦虑得分5(3~8)分,抑郁得分7(4~11)分。疲乏和疼痛、负性情绪、失眠均呈正相关关系(r值为0.432~0.950,P<0.01);负性情绪和失眠在疼痛和疲乏之间存在部分中介效应,总间接效应占总效应的56.44%。结论类风湿关节炎患者的疲乏为中等水平;疼痛、负性情绪、失眠和疲乏存在相关关系;负性情绪和失眠在疼痛和疲劳之间存在多重中介效应。

Objective To understand the relationship between pain,negative emotions(anxiety and depression),insomnia and fatigue in patients with rheumatoid arthritis,and explore the multiple mediating effects of negative emotions and insomnia on pain and fatigue.Methods A total of 240 patients with rheumatoid arthritis were selected from Northern Theater General Hospital from October 2018 to January 2019.The general questionnaire,Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire,Visual Analogue Scale,The Hospital Anxiety and Depression Scale and the Asens Insomnia Scale were used to investigate the demographic data,fatigue,pain,anxiety,depression,and insomnia,respectively.SPSS 20.0 was used for correlation analysis,and Mplus 7.0 was used for mediation analysis.Results The fatigue score of patients with rheumatoid arthritis was(28.88±14.89),which was moderate.The score of Visual Analogue Scale was 4(2-7),the score of insomnia was 7(3-11),the score of anxiety was 5(3-8),the score of depression was 7(4-11).There was a positive correlation between fatigue and pain,negative emotion and insomnia(r values were 0.432-0.950,P<0.01).Negative emotions and insomnia had a partial mediating effect between pain and fatigue,with mediating effects accounting for 56.44%of the total effect.Conclusions The fatigue of patients with rheumatoid arthritis is moderate;fatigue is associated with pain,negative emotions,and insomnia;negative emotions and insomnia have multiple mediating effects between pain and fatigue.