Analysis of the perception and influencing factors of pain catastrophizing in patients with axial spondyloarthritis

Abstract

Objective To investigate pain catastrophizing (PC) level and its influencing factors in patients with axial spondyloarthritis (axSpA) to provide basis for clinical interventions. Methods 296 patients with axSpA were recruited from a Grade Ⅲ Level A hospital in Guangzhou from July 2016 to May 2019. Scores of PC, pain intensity and interference, spinal mobility, functional ability, and disease activity in the past week were collected. Factors influencing PC were analyzed using nonparametric test, Spearman's correlation analysis, and logistic regression analysis. Results The total score of PC was 15.0(6.0, 28.0). Seventy patients (23.6%) had the tendency of PC with total score of 37.0 (32.0, 43.0). The worst, least, average, and current pain intensity and the overall pain interference were 4.0 (3.0, 6.0), 1.0 (0, 3.0), 3.0 (2.0, 4.0), 2.0 (1.0, 3.0) and 2.9 (1.5, 4.7), respectively, which were all positively correlated with the level of PC (r=0.428, 0.264, 0.421, 0.292, 0.592, P 4 and the Bath Ankylosing Spondylitis Functional Index (BASFI) ≥ 5 had higher PC scores[21.5(11.5, 32.5), 28.0(22.0, 38.0), respectively, P<0.05]. There was significant difference in PC among patients with different disease activity (Z=28.550, P<0.01). Logistic regression showed that the average pain intensity [OR=2.118, 95%CI(1.144, 3.923)] and overall pain interference [OR=4.506, 95%CI(2.339, 8.680)] were the independent influential factors. Conclusion PC exists in some patients with axSpA. The level of PC is associated with pain intensity and its interference, degree of spine activity, function, and disease activity. The average pain intensity and overall pain interference are independent risk factors of PC. Key words: Spondylarthritis; Pain; Cognition