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应对和疼痛干扰对军队准备的综合影响
Jessica L Kegel1,2, Josh B Kazman1,2, Daniel R Clifton1,2
1Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, United States.
Frontiers in pain research (Lausanne, Switzerland)
|September 1, 2023
概括
慢性疼痛显著影响军事准备,不有益的应对方式增加了医疗不准备. 然而,有益的应对策略可以减轻士兵的这些风险.
科学领域:
- 军事卫生研究军事卫生研究
- 服务人员的心理性.
- 疼痛管理和作战准备.
背景情况:
- 慢性疼痛及其对日常活动的干扰在军队中很普遍,影响三分之一的服务人员,并导致医疗准备不足 (MNR).
- 现有的研究表明心理因素,包括应对方式和疼痛干扰 (PI),影响功能结果,但美国陆军人口中的具体数据有限.
研究的目的:
- 研究疼痛干扰和应对策略对美国陆军士兵准备能力的综合影响.
- 分析全球评估工具 (GAT) 福利数据,应对机制和从职责限制记录中得出的医疗不准备 (MNR) 之间的关系.
主要方法:
- 利用了从2014年至2017年期间完成GAT的866,379名士兵的年度福利数据,随后通过2018年对义务限制进行了观察.
- 采用参数生存回归模型 (韦布尔分布) 来预测基于二分化的PI和分类的GAT应对组件 (良好应对,不良应对,灾难性灵活性,灾难性绝望) 的MNR的人口调整风险.
- 评估了所有职责限制的事件MNR,并根据特定的身体系统进行了分层分析 (上肢,下肢,精神病).
主要成果:
- 在经历疼痛干扰的士兵中,MNR的更高危险与无益的应对方式 (不良应对,绝望) 相联系.
- 相反,有利的应对方式 (良好的应对能力,灵活性) 与较低的MNR风险有关.
- 观察到PI和应对之间的显著相互作用,特别是在灾难化-绝望和与精神病有关的MNR.
结论:
- 研究结果表明,慢性疼痛和应对方式之间存在协同关系,可能会影响士兵的疼痛相关职业残疾.
- 应对技能是军事卫生计划中的慢性疼痛减轻和预防的可行干预目标,例如陆军的士弹性训练课程.
- 需要进行进一步的研究,以确定以应对方式为重点的早期干预措施是否可以有效地减少服务人员的与疼痛相关的结果.
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