期刊
CLINICAL JOURNAL OF PAIN
卷 32, 期 12, 页码 1076-1085出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AJP.0000000000000361
关键词
clinical pain; quantitative sensory testing; patient-provider interaction; temporal summation; racial discrimination
资金
- National Heart, Lung, and Blood Institute [R01HL98110]
- National Institutes of Health Ruth L. Kirschstein National Research Service Award [T32 NS070201]
- Career Development Award from the National Heart, Lung, and Blood Institute, Bethesda, MD [5K01HL108832-03]
Objective:People living with sickle cell disease (SCD) experience severe episodic and chronic pain and frequently report poor interpersonal treatment within health-care settings. In this particularly relevant context, we examined the relationship between perceived discrimination and both clinical and laboratory pain.Methods:Seventy-one individuals with SCD provided self-reports of experiences with discrimination in health-care settings and clinical pain severity, and completed a psychophysical pain testing battery in the laboratory.Results:Discrimination in health-care settings was correlated with greater clinical pain severity and enhanced sensitivity to multiple laboratory-induced pain measures, as well as stress, depression, and sleep. After controlling for relevant covariates, discrimination remained a significant predictor of mechanical temporal summation (a marker of central pain facilitation), but not clinical pain severity or suprathreshold heat pain response. Furthermore, a significant interaction between experience with discrimination and clinical pain severity was associated with mechanical temporal summation; increased experience with discrimination was associated with an increased correlation between clinical pain severity and temporal summation of pain.Discussion:Perceived discrimination within health-care settings was associated with pain facilitation. These findings suggest that discrimination may be related to increased central sensitization among SCD patients, and more broadly that health-care social environments may interact with pain pathophysiology.
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