两个地方请教一下

Disability and limitations of activity should not only be quantified in dollars but should also be measured according to their impact on quality of life. In 2006, a survey was conducted by the American Pain Foundation to evaluate the impact of chronic pain in over 300 patients. They found that almost two-thirds (59%) reported an impact on overall enjoyment of life with 77% having feelings of depression, 70% having trouble concentrating, 75% having decreased energy levels, and 86% having inability to sleep well [8]. The effects of pain can encompass an array of psychological and social consequences such as fear, depression, anxiety, and inability to fully participate in one’s social roles as a family member, friend, or employee [4]. All of these factors contribute to the unquantifiable costs of lost potential and decreased quality of life. For example, when people cannot fully participate in their social roles, it is common for significant stress on personal relationships to occur. Family members often find their relationships and social dynamics changing in the setting of chronic pain. They may need to take on new roles such as caregiver and take on a greater burden of responsibility within the family infrastructure. These strained relationships may further impact the patient’s recovery. For instance, it has been demonstrated that patients who reported having unsupportive families were more likely to have work-related injuries, rely on medication, and report more pain sites, more pain behavior, and more emotional stress [27]. In contrast to this, those with supportive families reported significantly less pain intensity, needed less medication, and were more active [27]. Though it is difficult to precisely measure the psychological and social significance of these effects, it is an important consideration for providers to take into account when developing a treatment plan for patients.

残疾和活动限制不应仅以美元量化，还应根据其对生活质量的影响来衡量。2006年，美国疼痛基金会进行了一项调查，评估了300多名患者慢性疼痛的影响。研究人员发现，近三分之二（59%）的人报告说对生活的总体幸福感有影响，这些人中77%有抑郁，70%注意力不集中，75%精力下降，86%睡眠质量降低^[8]。疼痛的影响包括一系列的心理和社会后果，如恐惧、抑郁、焦虑和无法充分参与作为家庭成员、朋友或雇员的社会角色^[4]。所有这些因素都是造成潜力丧失和生活质量下降的不可量化成本。例如，当人们不能充分参与他们的社会角色时，常常出现人际关系上的显著负担。慢性疼痛时，家庭成员常发现他们的关系和社会动态在发生变化。他们可能需要承担如照顾者这样的新角色，并在家庭基础设施中承担更大的责任。这些紧张的关系可能进一步影响病人的康复。例如已经证明的，据报告无家庭支持的患者，更有可能发生工伤、依赖药物、更多的疼痛部位、更多的疼痛行为和更多的情绪压力^[27]。与此相反，那些有家庭支持的人报告疼痛强度明显降低，需要更少的药物治疗，并且活动更多^[27]。虽然很难精确地衡量这些影响的心理和社会意义，但在为患者制定治疗计划时，是需要考虑的一个重要因素。

1.find sth changing，changing是宾语补足语吗？dynamics changing既然是动态，还有什么changing的？

2.family infrastructure 家庭的责任和义务？