Self-Reported Disability in Persons With HIV-Related Neuropathy Is Mediated by Pain Interference and Depression

Abstract Objective The purpose of this study was to compare disability in people with HIV and peripheral neuropathy with those without neuropathy and explore how neuropathy and other relevant factors are associated with disability. Methods In this cross-sectional study, participants completed the Br...

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Veröffentlicht in:Physical therapy 2020-12, Vol.100 (12), p.2174-2185
Hauptverfasser: Kietrys, David M, Parrott, James Scott, Galantino, Mary Lou, Davis, Tracy, Levin, Todd, O’Brien, Kelly K
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container_end_page 2185
container_issue 12
container_start_page 2174
container_title Physical therapy
container_volume 100
creator Kietrys, David M
Parrott, James Scott
Galantino, Mary Lou
Davis, Tracy
Levin, Todd
O’Brien, Kelly K
description Abstract Objective The purpose of this study was to compare disability in people with HIV and peripheral neuropathy with those without neuropathy and explore how neuropathy and other relevant factors are associated with disability. Methods In this cross-sectional study, participants completed the Brief pain inventory, Beck Depression Inventory II, World Health Organization Disability Assessment Schedule (WHODAS 2.0), and a health and demographic questionnaire. Additional data were extracted from the medical record. A raw score of ≥1 on the Subjective Peripheral Neuropathy Screen questions about lower extremity numbness or paresthesia was used to identify peripheral neuropathy. Predictors of disability (as determined by association with World Health Organization Disability Assessment Schedule 2.0 scores) were evaluated bivariately and in a multivariable model. Path modeling was used to identify a parsimonious model to elucidate the mediated effects of peripheral neuropathy on disability. Results Participants with peripheral neuropathy had more depression symptoms, more pain (severity and interference), and higher disability scores compared with participants without neuropathy. The relationship between neuropathy and disability was mediated by pain interference and depression (standardized root mean residual = .056). Conclusion In this sample of people with HIV, those with lower extremity peripheral neuropathy reported more severe disability, worse pain, and more depression symptoms than those without neuropathy. The relationship between peripheral neuropathy and disability may be mediated though pain interference and depression. Impact Distal sensory polyneuropathy is a common comorbidity experienced by people living with HIV and frequently causes pain. This study can help providers direct care toward lessening disability experienced among people with HIV and peripheral neuropathy by targeting interventions for treatment of pain and depression. Lay Summary People living with HIV may experience disabling painful neuropathy. Treatment for pain and depression may help reduce the disability associated with painful neuropathy.
doi_str_mv 10.1093/ptj/pzaa161
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Methods In this cross-sectional study, participants completed the Brief pain inventory, Beck Depression Inventory II, World Health Organization Disability Assessment Schedule (WHODAS 2.0), and a health and demographic questionnaire. Additional data were extracted from the medical record. A raw score of ≥1 on the Subjective Peripheral Neuropathy Screen questions about lower extremity numbness or paresthesia was used to identify peripheral neuropathy. Predictors of disability (as determined by association with World Health Organization Disability Assessment Schedule 2.0 scores) were evaluated bivariately and in a multivariable model. Path modeling was used to identify a parsimonious model to elucidate the mediated effects of peripheral neuropathy on disability. Results Participants with peripheral neuropathy had more depression symptoms, more pain (severity and interference), and higher disability scores compared with participants without neuropathy. The relationship between neuropathy and disability was mediated by pain interference and depression (standardized root mean residual = .056). Conclusion In this sample of people with HIV, those with lower extremity peripheral neuropathy reported more severe disability, worse pain, and more depression symptoms than those without neuropathy. The relationship between peripheral neuropathy and disability may be mediated though pain interference and depression. Impact Distal sensory polyneuropathy is a common comorbidity experienced by people living with HIV and frequently causes pain. This study can help providers direct care toward lessening disability experienced among people with HIV and peripheral neuropathy by targeting interventions for treatment of pain and depression. Lay Summary People living with HIV may experience disabling painful neuropathy. Treatment for pain and depression may help reduce the disability associated with painful neuropathy.</description><identifier>ISSN: 0031-9023</identifier><identifier>EISSN: 1538-6724</identifier><identifier>DOI: 10.1093/ptj/pzaa161</identifier><identifier>PMID: 32914180</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Care and treatment ; Cross-Sectional Studies ; Depression (Mood disorder) ; Depression - complications ; Depression - psychology ; Depression, Mental ; Diagnosis ; Disability Evaluation ; Disabled persons ; Female ; Health Surveys ; HIV ; HIV Infections - complications ; HIV patients ; Human immunodeficiency virus ; Humans ; Hypesthesia - diagnosis ; Hypesthesia - etiology ; Lower Extremity ; Male ; Medical examination ; Mental depression ; Middle Aged ; Pain ; Pain - complications ; Pain management ; Pain Measurement - methods ; Paresthesia - diagnosis ; Paresthesia - etiology ; Patient outcomes ; Peripheral nerve diseases ; Peripheral nervous system diseases ; Peripheral Nervous System Diseases - complications ; Peripheral Nervous System Diseases - diagnosis ; Peripheral Nervous System Diseases - etiology ; Peripheral neuropathy ; Regression Analysis ; Self examination (Medical) ; Self Report</subject><ispartof>Physical therapy, 2020-12, Vol.100 (12), p.2174-2185</ispartof><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><rights>COPYRIGHT 2020 Oxford University Press</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c630t-4ecf86f6be60ee94b22cf47500dd1ac5a89eca7d5d377e7f5ed8c57c268cc40b3</citedby><cites>FETCH-LOGICAL-c630t-4ecf86f6be60ee94b22cf47500dd1ac5a89eca7d5d377e7f5ed8c57c268cc40b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32914180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kietrys, David M</creatorcontrib><creatorcontrib>Parrott, James Scott</creatorcontrib><creatorcontrib>Galantino, Mary Lou</creatorcontrib><creatorcontrib>Davis, Tracy</creatorcontrib><creatorcontrib>Levin, Todd</creatorcontrib><creatorcontrib>O’Brien, Kelly K</creatorcontrib><title>Self-Reported Disability in Persons With HIV-Related Neuropathy Is Mediated by Pain Interference and Depression</title><title>Physical therapy</title><addtitle>Phys Ther</addtitle><description>Abstract Objective The purpose of this study was to compare disability in people with HIV and peripheral neuropathy with those without neuropathy and explore how neuropathy and other relevant factors are associated with disability. Methods In this cross-sectional study, participants completed the Brief pain inventory, Beck Depression Inventory II, World Health Organization Disability Assessment Schedule (WHODAS 2.0), and a health and demographic questionnaire. Additional data were extracted from the medical record. A raw score of ≥1 on the Subjective Peripheral Neuropathy Screen questions about lower extremity numbness or paresthesia was used to identify peripheral neuropathy. Predictors of disability (as determined by association with World Health Organization Disability Assessment Schedule 2.0 scores) were evaluated bivariately and in a multivariable model. Path modeling was used to identify a parsimonious model to elucidate the mediated effects of peripheral neuropathy on disability. Results Participants with peripheral neuropathy had more depression symptoms, more pain (severity and interference), and higher disability scores compared with participants without neuropathy. The relationship between neuropathy and disability was mediated by pain interference and depression (standardized root mean residual = .056). Conclusion In this sample of people with HIV, those with lower extremity peripheral neuropathy reported more severe disability, worse pain, and more depression symptoms than those without neuropathy. The relationship between peripheral neuropathy and disability may be mediated though pain interference and depression. Impact Distal sensory polyneuropathy is a common comorbidity experienced by people living with HIV and frequently causes pain. This study can help providers direct care toward lessening disability experienced among people with HIV and peripheral neuropathy by targeting interventions for treatment of pain and depression. Lay Summary People living with HIV may experience disabling painful neuropathy. 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Physical therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kietrys, David M</au><au>Parrott, James Scott</au><au>Galantino, Mary Lou</au><au>Davis, Tracy</au><au>Levin, Todd</au><au>O’Brien, Kelly K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Self-Reported Disability in Persons With HIV-Related Neuropathy Is Mediated by Pain Interference and Depression</atitle><jtitle>Physical therapy</jtitle><addtitle>Phys Ther</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>100</volume><issue>12</issue><spage>2174</spage><epage>2185</epage><pages>2174-2185</pages><issn>0031-9023</issn><eissn>1538-6724</eissn><abstract>Abstract Objective The purpose of this study was to compare disability in people with HIV and peripheral neuropathy with those without neuropathy and explore how neuropathy and other relevant factors are associated with disability. Methods In this cross-sectional study, participants completed the Brief pain inventory, Beck Depression Inventory II, World Health Organization Disability Assessment Schedule (WHODAS 2.0), and a health and demographic questionnaire. Additional data were extracted from the medical record. A raw score of ≥1 on the Subjective Peripheral Neuropathy Screen questions about lower extremity numbness or paresthesia was used to identify peripheral neuropathy. Predictors of disability (as determined by association with World Health Organization Disability Assessment Schedule 2.0 scores) were evaluated bivariately and in a multivariable model. Path modeling was used to identify a parsimonious model to elucidate the mediated effects of peripheral neuropathy on disability. Results Participants with peripheral neuropathy had more depression symptoms, more pain (severity and interference), and higher disability scores compared with participants without neuropathy. The relationship between neuropathy and disability was mediated by pain interference and depression (standardized root mean residual = .056). Conclusion In this sample of people with HIV, those with lower extremity peripheral neuropathy reported more severe disability, worse pain, and more depression symptoms than those without neuropathy. The relationship between peripheral neuropathy and disability may be mediated though pain interference and depression. Impact Distal sensory polyneuropathy is a common comorbidity experienced by people living with HIV and frequently causes pain. This study can help providers direct care toward lessening disability experienced among people with HIV and peripheral neuropathy by targeting interventions for treatment of pain and depression. Lay Summary People living with HIV may experience disabling painful neuropathy. Treatment for pain and depression may help reduce the disability associated with painful neuropathy.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>32914180</pmid><doi>10.1093/ptj/pzaa161</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Oxford Journals Online; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Care and treatment
Cross-Sectional Studies
Depression (Mood disorder)
Depression - complications
Depression - psychology
Depression, Mental
Diagnosis
Disability Evaluation
Disabled persons
Female
Health Surveys
HIV
HIV Infections - complications
HIV patients
Human immunodeficiency virus
Humans
Hypesthesia - diagnosis
Hypesthesia - etiology
Lower Extremity
Male
Medical examination
Mental depression
Middle Aged
Pain
Pain - complications
Pain management
Pain Measurement - methods
Paresthesia - diagnosis
Paresthesia - etiology
Patient outcomes
Peripheral nerve diseases
Peripheral nervous system diseases
Peripheral Nervous System Diseases - complications
Peripheral Nervous System Diseases - diagnosis
Peripheral Nervous System Diseases - etiology
Peripheral neuropathy
Regression Analysis
Self examination (Medical)
Self Report
title Self-Reported Disability in Persons With HIV-Related Neuropathy Is Mediated by Pain Interference and Depression
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