Dahl B, Gehrchen P M, Kiaer T, Blyme P, Tøndevold E, Bendix T
Department of Orthopaedic Surgery, Rigshospitalet, University Hospital of Copenhagen, Denmark.
Eur Spine J. 2001 Jun;10(3):211-4. doi: 10.1007/s005860100266.
The Short Form 36 questionnaire (SF-36) measures general health and well-being. Within the last 5 years it has been used increasingly to characterise patients in the medical literature. Relatively few studies have used the SF-36 on patients with chronic low back pain undergoing preoperative evaluation, but results suggest that it may be predictive of surgical outcome. Pain drawings are a routine part of evaluation prior to spinal surgery in several centres, since their classification of organic or nonorganic has been shown in some studies to correlate well with psychological characteristics predicting poor outcome. The purpose of the present study was to assess possible correlations between nonorganic pain drawings and the psychological scales in the SF-36. We included 128 patients in the study, all of them referred from other hospitals. Previous spinal surgery had been undergone by 25%, and 59% required daily medication because of low back pain. All patients completed pain drawings using predefined symbols These pain drawings were scored dichotomously as organic or nonorganic based on a brief description of a typical nonorganic characteristics. Patients also completed the Danish version of the SF-36 questionnaire. Statistical analysis was performed using logistic regression analysis. The pain drawing classification was used as the dependent variable and scores on the eight scales of the SF-36 as independent variables. P values of <0.05 were considered significant. The mean scores of the patient population on all eight scales were significantly lower than Danish norms. The only scales that correlated with the presence of nonorganic pain drawings were emotional role (RE) and mental health (MH), both measuring psychological health. The odds ratio (OR) of receiving a nonorganic pain drawing was 22 (95% confidence interval, or CI, 7-65) if the scores on RE and MH were more than 2 standard deviations (SD) below the Danish norm. This is the first study providing evidence that pain drawing ratings are influenced by the psychological scales of the SF-36. The clinical relevance of this observation regarding prediction of outcome after spinal surgery should be assessed in future studies.
简短健康调查问卷（SF - 36）用于衡量总体健康状况和幸福感。在过去5年里，它在医学文献中越来越多地被用于描述患者特征。相对较少的研究将SF - 36用于接受术前评估的慢性下腰痛患者，但结果表明它可能预测手术结果。疼痛绘图是几个中心脊柱手术术前评估的常规部分，因为在一些研究中已表明其对器质性或非器质性的分类与预测不良结果的心理特征密切相关。本研究的目的是评估非器质性疼痛绘图与SF - 36中的心理量表之间可能存在的相关性。我们纳入了128例研究患者，均来自其他医院转诊。25%的患者曾接受过脊柱手术，59%的患者因下腰痛需要每日服药。所有患者使用预定义符号完成疼痛绘图。根据典型非器质性特征的简要描述，这些疼痛绘图被二分法评定为器质性或非器质性。患者还完成了丹麦版的SF - 36问卷。采用逻辑回归分析进行统计分析。疼痛绘图分类用作因变量，SF - 36八个量表的得分用作自变量。P值<0.05被认为具有统计学意义。患者群体在所有八个量表上的平均得分显著低于丹麦标准。与非器质性疼痛绘图存在相关的唯一量表是情感角色（RE）和心理健康（MH），二者均用于测量心理健康。如果RE和MH的得分比丹麦标准低2个标准差（SD）以上，获得非器质性疼痛绘图的比值比（OR）为22（95%置信区间，CI，7 - 65）。这是第一项提供证据表明疼痛绘图评分受SF - 36心理量表影响的研究。这一观察结果在脊柱手术后结果预测方面的临床相关性应在未来研究中进行评估。
