Exploring Gender Differences in Veterans in a Secondary Analysis of a Randomized Controlled Trial of Mindfulness for Chronic Pain

Diana J Burgess^{1

2}, Emily M Hagel Campbell¹, Mariah Branson¹, Collin Calvert^{1

2}, Roni Evans³, Kelli D Allen^{4

5}, Ann Bangerter¹, Lee J S Cross¹, Mary A Driscoll^{6

7}, Sierra Hennessy¹, John E Ferguson², Jessica K Friedman⁸, Marianne S Matthias^{9

10

11}, Laura A Meis^{1

2}, Melissa A Polusny^{1

2}, Stephanie L Taylor^{8

12

13}, Brent C Taylor^{1

2}

Affiliations

¹ VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA.
² Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
³ Integrative Health and Wellbeing Research Program, Center for Spirituality and Healing, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA.
⁴ VA HSR&D Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
⁵ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, USA.
⁶ Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Health Care System, West Haven, Connecticut, USA.
⁷ Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
⁸ VA HSR&D Center for the Study of Health Care Innovation, Implementation and Policy, Greater Los Angeles VA Health Care System, Los Angeles, California, USA.
⁹ VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana, USA.
¹⁰ Regenstrief Institute, Indianapolis, Indiana, USA.
¹¹ Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, USA.
¹² Department of Health Policy and Management, UCLA School of Public Health, Los Angeles, California, USA.
¹³ Department of Medicine, UCLA School of Medicine, Los Angeles, California, USA.

PMID: 38404673
PMCID: PMC10890953
DOI: 10.1089/whr.2023.0086

Exploring Gender Differences in Veterans in a Secondary Analysis of a Randomized Controlled Trial of Mindfulness for Chronic Pain

Diana J Burgess et al. Womens Health Rep (New Rochelle). 2024.

. 2024 Feb 12;5(1):82-92.

doi: 10.1089/whr.2023.0086. eCollection 2024.

Authors

Affiliations

¹ VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA.
² Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
³ Integrative Health and Wellbeing Research Program, Center for Spirituality and Healing, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA.
⁴ VA HSR&D Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
⁵ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, USA.
⁶ Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Health Care System, West Haven, Connecticut, USA.
⁷ Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
⁸ VA HSR&D Center for the Study of Health Care Innovation, Implementation and Policy, Greater Los Angeles VA Health Care System, Los Angeles, California, USA.
⁹ VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana, USA.
¹⁰ Regenstrief Institute, Indianapolis, Indiana, USA.
¹¹ Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, USA.
¹² Department of Health Policy and Management, UCLA School of Public Health, Los Angeles, California, USA.
¹³ Department of Medicine, UCLA School of Medicine, Los Angeles, California, USA.

PMID: 38404673
PMCID: PMC10890953
DOI: 10.1089/whr.2023.0086

Abstract

Background: Although studies have documented higher rates of chronic pain among women Veterans compared to men Veterans, there remains a lack of comprehensive information about potential contributors to these disparities.

Materials and methods: This study examined gender differences in chronic pain and its contributors among 419 men and 392 women Veterans, enrolled in a mindfulness trial for chronic pain. We conducted descriptive analyses summarizing distributions of baseline measures, obtained by survey and through the electronic health record. Comparisons between genders were conducted using chi-square tests for categorical variables and t-tests for continuous measures.

Results: Compared to men, women Veterans were more likely to have chronic overlapping pain conditions and had higher levels of pain interference and intensity. Women had higher prevalence of psychiatric and sleep disorder diagnoses, greater levels of depression, anxiety, post-traumatic stress disorder, fatigue, sleep disturbance, stress and pain catastrophizing, and lower levels of pain self-efficacy and participation in social roles and activities. However, women were less likely to smoke or have a substance abuse disorder and used more nonpharmacological pain treatment modalities.

Conclusion: Among Veterans seeking treatment for chronic pain, women differed from men in their type of pain, had greater pain intensity and interference, and had greater prevalence and higher levels of many known biopsychosocial contributors to pain. Results point to the need for pain treatment that addresses the comprehensive needs of women Veterans.

Clinical Trial Registration Number: NCT04526158. Patient enrollment began on December 4, 2020.

Keywords: chronic pain; mindfulness; veterans; women.

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Conflict of interest statement

No competing financial interests exist.

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References

1. Osborne NR, Davis KD. Sex and gender differences in pain. Int Rev Neurobiol 2022;164:277–307; doi: 10.1016/bs.irn.2022.06.013 - DOI - PubMed
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Exploring Gender Differences in Veterans in a Secondary Analysis of a Randomized Controlled Trial of Mindfulness for Chronic Pain

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Exploring Gender Differences in Veterans in a Secondary Analysis of a Randomized Controlled Trial of Mindfulness for Chronic Pain

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