De Souza L H, Frank A O
Centre for Research in Rehabilitation, Brunel University, UK.
Physiother Res Int. 2000;5(4):207-19. doi: 10.1002/pri.201.
Studies into the effect of pain experience on those who have it have largely focused on the views and interpretations of researchers gained by the use of assessment tools aimed at measuring pain. The purpose of this study was to explore and describe pain, as experienced by those with chronic back pain, and to document 'insider' accounts of how pain is perceived and understood by those who have it.
Unstructured interviews using the framework approach. Subjects were sampled for age, sex, ethnicity and occupation, from new referrals with back pain to a rheumatology outpatient clinic. Eleven subjects (5 M; 6 F) agreed to be interviewed. Interviews were unstructured, but followed a topic guide. Subjects were interviewed in English (nine) or their preferred language (two). Tape-recordings of interviews were transcribed verbatim and read in depth twice to identify the topics or concepts. Data were extracted in the form of words and phrases by use of thematic content analysis. The themes were pain description and amount of pain. An independent researcher reviewed the data and confirmed or contended the analysis.
All subjects, except one, provided descriptors of the quality of their pain. The use of simile was common to emphasize both what the pain was, and what it was not. Five subjects expressed a loss of words in trying to describe their pain. Only 13 of 29 different pain descriptors used were commensurate with those in the McGill Pain Questionnaire (Melzack, 1983). Subjects had great difficulty quantifying their pain intensity. Several explained how the pain fluctuated, thus, quantifying pain at one point in time was problematic. Only one subject offered a numerical description of pain intensity.
Subjects provided graphic and in-depth descriptions of their pain experience, but these bore little resemblance to commonly used assessment tools. The findings challenge the appropriateness of such formal instruments.
关于疼痛体验对患者影响的研究，很大程度上聚焦于研究者通过旨在测量疼痛的评估工具所获得的观点和解读。本研究的目的是探索和描述慢性背痛患者所经历的疼痛，并记录患者自身对于疼痛的感知和理解。
采用框架法进行非结构化访谈。从转介至风湿病门诊的背痛新患者中，按年龄、性别、种族和职业进行抽样。11名受试者（5名男性；6名女性）同意接受访谈。访谈为非结构化，但遵循主题指南。受试者用英语（9名）或其首选语言（2名）接受访谈。访谈录音逐字转录，并深入阅读两次以确定主题或概念。通过主题内容分析以单词和短语的形式提取数据。主题为疼痛描述和疼痛程度。一名独立研究人员审查了数据，并确认或反驳了分析结果。
除一名受试者外，所有受试者都提供了疼痛性质的描述词。使用比喻来强调疼痛是什么以及不是什么很常见。5名受试者在试图描述疼痛时表示词穷。在使用的29个不同疼痛描述词中，只有13个与麦吉尔疼痛问卷（梅尔扎克，1983年）中的描述词一致。受试者在量化疼痛强度方面有很大困难。有几名受试者解释了疼痛是如何波动的，因此，在某一时刻量化疼痛是有问题的。只有一名受试者提供了疼痛强度的数值描述。
受试者对其疼痛体验进行了生动而深入的描述，但这些描述与常用的评估工具几乎没有相似之处。这些发现对这类正式工具的适用性提出了质疑。
