ArticleFrontiers in public health2025
The relationship between chronic pain and health-related quality of life: the mediating roles of frailty and depression in chronic disease patients.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Can Chronic Pain Accelerate Chronic Kidney Disease? Is Pain a Disease Modifier Rather than a Symptom?Life (Basel, Switzerland) · 2026Article
- Predictive analysis of health-related quality of life trajectories in older patients with chronic pain based on explainable machine learning models.Health and quality of life outcomes · 2026Article
- Frailty as an indicator of adverse health outcomes in rheumatoid arthritis: a multicenter cross-sectional study.Arthritis research & therapy · 2026Article
- Latent profile classification of cognitive function and its influencing factors in elderly patients with chronic pain after stroke.Frontiers in neuroscience · 2026Article
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14 authors.
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Abstract
Introduction: Chronic pain (CP) is a prevalent comorbidity in patients with chronic diseases, yet the relationship between CP and health-related quality of life (HRQoL) remain unclear, particularly through the mediating roles of frailty and depression. Methods: We conducted a cross-sectional survey in two provinces (eastern and central China) from October 2024 to January 2025, enrolling 3,094 patients with chronic diseases. HRQoL was assessed using the EQ-5D scale, while CP status was determined through structured logic-based questions. Frailty was evaluated using the FRAIL scale, and depressive symptoms were measured with the CES-D10. Spearman's correlation analysis was performed to assess associations among CP, frailty, depression, and HRQoL. A chain mediation model (PROCESS 4.1, Model 6) was constructed, and mediation effects were tested using a bootstrap approach with 5,000 resamples. Results: Frailty and depression exhibited significant mediating effects in the relationship between CP and HRQoL. The indirect effects of frailty and depression on HRQoL were -0.0747 (95% CI: -0.0881, -0.0618) and -0.0211 (95% CI: -0.0297, -0.0135). Additionally, a significant chain mediation effect was observed (-0.0192, 95% CI: -0.0242, -0.0145). The indirect effect of frailty and depression accounted for 34.09% of the association between CP and HRQoL (total effect: -0.1150, 95% CI: -0.1305, -0.0999). Conclusion: The study findings demonstrated that frailty and depression serve as significant chain mediators in the relationship between CP and diminished HRQoL. Measures should be taken to reduce the incidence and severity of CP in patients with chronic diseases, improve frailty and depression, and thus improve HRQoL.
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