Jensen M P, Turner J A, Romano J M, Fisher L D
Department of Rehabilitation Medicine, Box 356490, University of Washington School of Medicine, Seattle 98195-6490, USA.
Pain. 1999 Nov;83(2):157-62. doi: 10.1016/s0304-3959(99)00101-3.
Reliable and valid measures of pain are essential for conducting research on chronic pain. The purpose of this longitudinal study was to compare the reliability and validity of several measures of pain intensity. One hundred twenty-three patients with chronic pain were administered telephone interview versions of 0-10 scales of current, worst, least and average pain, immediately prior to beginning a multidisciplinary treatment program. The measures were administered again to these subjects 2 weeks (n=108), 1 month (n=106) and 2 months (n=105) after the end of treatment. The validity (defined as ability to detect changes in pain intensity over the course of treatment up to the 2-month follow-up assessment) and reliability (defined as stability over time in the 2 months after treatment) of these four measures and of composite combinations of these measures were examined. Contrary to prediction, the composite measures did not show a statistically significant superiority to the individual ratings in terms of their ability to detect change in pain intensity from pre-treatment to various points after treatment. The composite scores did, however, show greater stability than did the individual ratings after treatment. The practical conclusions of this study are; (1), individual 0-10 pain intensity ratings have sufficient psychometric strengths to be used in chronic pain research, especially research that involves group comparison designs with relatively large sample sizes, but, (2), composites of 0-10 ratings may be more useful when maximal reliability is necessary, (e.g. in studies with relatively small sample sizes, or in clinical settings where monitoring of changes in pain intensity in individuals is needed).
可靠且有效的疼痛测量方法对于开展慢性疼痛研究至关重要。这项纵向研究的目的是比较几种疼痛强度测量方法的可靠性和有效性。123名慢性疼痛患者在开始多学科治疗项目之前，接受了关于当前、最严重、最轻和平均疼痛的0至10分制电话访谈版本测量。在治疗结束后的2周（n = 108）、1个月（n = 106）和2个月（n = 105），再次对这些受试者进行测量。研究考察了这四种测量方法及其综合组合的有效性（定义为在长达2个月的随访评估期间检测疼痛强度变化的能力）和可靠性（定义为治疗后2个月内随时间的稳定性）。与预测相反，综合测量方法在检测从治疗前到治疗后各时间点疼痛强度变化的能力方面，并未显示出在统计学上显著优于个体评分。然而，综合评分在治疗后确实比个体评分表现出更大的稳定性。本研究的实际结论是：（1），个体0至10分的疼痛强度评分具有足够的心理测量优势，可用于慢性疼痛研究，特别是涉及相对大样本量的组间比较设计的研究，但是，（2），当需要最大可靠性时（例如在样本量相对较小的研究中，或在需要监测个体疼痛强度变化的临床环境中），0至10分评分的综合可能更有用。
