The prevalence of pain and its association with psychosocial factors for indigent adults enrolled in a primary care clinic

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Clinical Journal of Pain





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adult, African American, African Americans, Age Distribution, article, Catastrophization, catastrophizing, Comorbidity, controlled study, coping behavior, Cross-Sectional Studies, cross-sectional study, depression, female, functional status, human, Humans, indigent, Indigent adults, major clinical study, male, Michigan, middle aged, pain, perception, poverty, prevalence, Primary care, Primary health care, primary medical care, priority journal, psychology, psychosocial care, Risk Factors, Sex Distribution, sleep, walking, work capacity


Objectives: Pain is a symptom reported in 50% to 70% of primary care visits and negatively impacts both physical and psychological functioning. People at risk of receiving inadequate management of pain include the indigent and people of color. The purpose of this exploratory, descriptive, cross-sectional study was to describe the prevalence of pain and its relation to functional status, depressive symptoms, perception of control over pain and coping in an urban, primary care clinic for indigent adults. Methods: Individuals (N=301) attending a primary care clinic for indigent adults were surveyed. Patients were 22 to 64 years of age, experienced pain during the past 2 weeks, and were able to understand and respond in English. Results: Ninety-two percent of the sample was African American and the average worst pain score was 8.4/10. The majority of patients had depression symptoms (77%), with pain most affecting patients' function with sleep, ability to work, and walking. Patients reporting higher pain scores had significantly lower perception of control over pain and reduced control over life in general. Higher reported pain levels were also significantly correlated with higher catastrophizing, depressive symptoms, and interference with function scores. Discussion: Pain levels were reported as high and affected psychological and physical functioning. This study was unique in the high percentage of African American participants and being conducted in a primary care clinic for indigent adults. Greater understanding of this population's pain will assist clinicians to assess pain comprehensively, provide education, and make treatment decisions for these patients. Copyright © 2013 by Lippincott Williams & Wilkins.