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Psychosocial experiences among primary care patients with and without musculoskeletal pain.
Authors:Joaquim J F Soares  Beata Jablonska
Affiliation:Unity of Mental Health, Samh?llsmedicin (Department of Public Health Sciences, Division of Social Medicine, Karolinska Institute), Box 175 33, Wollmar, Yxkullsgatan 19, SE-118 91, Stockholm, Sweden
Abstract:We examined differences in demographic/financial characteristics, burnout, job demands/control/strain and symptoms of depression as measured by GHQ among primary care patients with (n=838) and without pain (n=135). In addition, we examined factors associated with the presence of pain by means of logistic regression analyses among all participants, and inter-relations between demographic/financial/pain/health variables, symptoms of depression, burnout, and disability by means of multivariate regression analyses among pain patients. The patients completed a questionnaire about areas such as job strain and burnout. The design was cross-sectional and data were collected during 15 consecutive days. The univariate analyses showed that pain patients, compared with patients without pain, were more often females, older, divorced, foreign-born, had been more often on sick-leave, were more preoccupied with how to make ends meet and had greater difficulties in raising a reasonable sum of money within a specific period of time. In addition, they had greater levels of depression symptoms, burnout, and job strain. However, the multivariate analyses showed that symptoms of depression and burnout were more associated with such variables as sick-leave and divorce than by pain parameters. The logistic regression revealed that the presence of pain was associated with female gender, sick-leave, and high levels of job strain and mean total burnout. Finally, pain patients had a severe clinical situation in terms of, for example, constant, intense, and prolonged pain, and experienced a high degree of disability due to pain. We corroborated previous findings and may have provided new insights into the experiences of pain patients that may be of importance when considering intervention. Although we pointed to some important factors associated with pain, symptoms of depression and burnout, much of their variation remains to be explained. Thus, further research appears necessary, not least concerning the role of burnout as an antecedent to pain.
Keywords:Primary care patients  Pain  Burnout  Depression  Job demands/control/strain
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