Psychosocial Underpinnings of Pain and Sleep Disturbance in Safety-Net Primary Care Patients

Abstract

Objective. The aim of this study was to uncover possible psychosocial underpinnings of pain and sleep disturbance in a safety-net primary care sample. Methods. Patients (n = 210) awaiting care in a safety-net primary care clinic waiting room completed measures of cynical hostility, social support, mental health, sleep disturbance, and pain. This study was cross-sectional and observational. Results. A structural equation model suggested that higher cynical hostility was associated with lower social support, which in turn was associated with poorer mental health, which then corresponded with higher pain and sleep disturbance. All possible indirect (mediational) effects within this model were statistically significant, suggesting a possible route through which cynical hostility may shape pain and sleep, two common presenting problems in primary care. Conclusions. These findings illustrate the interplay of psychosocial factors with chronic pain and sleep disturbance in a sample of low-income, predominantly African-American patients seeking care at a safety-net primary care clinic. The findings support integrated primary care as a way to target not only behavioral health issues but also the psychosocial factors entangled with physical health.

The impact of fear and anxiety of Covid-19 on life satisfaction: Psychological distress and sleep disturbance as mediators

“… Han et al (2021) revealed that a change in psychological distress and anxiety can lead to short-term sleep disturbance while Cheung and Yip (2015) also emphasize that individual with more severe anxiety and depression have greater degree of sleep disturbance. Moreover, although the correlation between psychological distress and sleep disturbances has been documented in previous studies ( Chueh et al, 2019 ; Duraku et al, 2020 ; Jiang et al, 2020 ; Griffin et al, 2020 ; Wang et al, 2020 ), almost all these studies only focused on either nurses ( Chueh et al, 2019 ); patients ( Griffin et al, 2020 ; Jiang et al, 2020 ), or adolescents ( Duraku et al, 2020 ). Kalyani et al (2017) argue that estimating the effect of psychological distress on sleep disturbance among young population, especially for college students, is needed to preserve the ‘health of the society’ later generations.…”

“… Feng et al, 2020 ). Secondly , Jiang et al (2020) argued that psychological distress was significantly correlated with sleep quality of patients who inflected by covid-19 in Wuhan, while Griffin et al (2020) also found that there was a significant relationship between mental health and sleep disturbance of safety-net primary care clinic patients. Yet, most prior researches only focused on inflected individuals, there are few studies on discovering the effects of fear and anxiety of covid-19, psychological distress on sleep disturbance among uninflected people, particularly for college students, who dramatically affected by the social distancing, self-isolation, and university closures.…”

Impairment of quality of life due to anxiety and depression in patients with chronic pain

“…In the long term, the following were observed: worsening of sleep disturbances with job loss, sequelae from accidents, rupture of relationships, and the appearance or worsening of health problems. This association between sleep disorders, its negative consequences and CP is already well established in the literature 38 .…”