摘要：Objectives. We examined the association between pain-related activity difficulty (PRAD) in the past 30 days and health-related quality of life, health behaviors, disability indices, and major health impairments in the general US population. Methods. We obtained data from 18 states in the 2002 Behavioral Risk Factor Surveillance System, an ongoing, cross-sectional, state-based, random-digit-dialed telephone survey of noninstitutionalized adults aged 18 years or older. Results. Nearly one quarter of people in the 18 states and the District of Columbia reported at least 1 day of PRAD in the past 30 days. PRAD was associated with obesity, smoking, physical inactivity, impaired general health, infrequent vitality, and frequent occurrences of physical distress, mental distress, depressive symptoms, sleep insufficiency, and anxiety symptoms. Moreover, a general dose–response relationship was noted between increased days of PRAD and increased prevalence of impaired health-related quality of life, disability indices, and health risk behaviors. Conclusion. Pain negatively influences various domains of health, not only among clinical populations, but also in the general community, suggesting a critical need for the dissemination of targeted interventions to enhance recognition and treatment of pain among adult community-dwellers. Pain has been defined as an unpleasant sensory or emotional experience associated with potential or actual tissue damage. 1 Chronic pain affects about 90 million Americans 2 and nearly half of the US population sees a physician primarily because of pain each year. 3 Pain may manifest in a variety of ways including acute events (e.g., injury), chronic episodic conditions (e.g., migraine headaches), and chronic persistent problems (e.g., arthritis) 4 and may be neurogenic or psychogenic in nature. 5 Notably, people who live with persistent pain are 4 times more likely than those without pain to suffer from depression or anxiety and more than twice as likely to have difficulty working. 6 Conditions associated with pain cost US companies approximately $61.2 billion per year, primarily because of impaired work performance. 4 In addition, pain accounts for 20% of medical visits and 10% of prescription drug sales. 7 In declaring 2001 to 2011 to be the “Decade of Pain Control and Research,” Congress provided much-needed recognition of this frequently chronic and potentially disabling condition. 8 , 9 Pain is widely accepted as one of the most important determinants of quality of life because of its widespread adverse effects, including diminishing mental health and well-being and impairing the individual’s ability to perform daily activities. 3 Although numerous studies have examined the association between pain and health-related quality of life (HRQOL) in countries outside the United States and in clinical populations suffering from specific conditions, no studies were found examining associations between days of pain-related activity difficulty (PRAD), HRQOL, health behaviors, disability indices, and major impairments among US community-dwellers. To examine these associations, data were analyzed from the 2002 survey of the Behavioral Risk Factor Surveillance System (BRFSS).
