McCracken Lance M, Evon Donna, Karapas Eleftheria T
Department of Psychiatry, The University of Chicago, Chicago, USA.
Eur J Pain. 2002;6(5):387-93. doi: 10.1016/s1090-3801(02)00042-3.
Treatment satisfaction is an increasingly popular outcome measure in pain management. While it is a subjective variable, it may nonetheless reflect the quality of care and it may predict other important patient behaviors. The purpose of this study was to prospectively evaluate predictors of satisfaction with treatment for chronic pain. Subjects included 62 adults seeking treatment for pain at a community-based, specialty clinic. Treatment included combinations of analgesic medications (e.g., opioids, tricyclic antidepressants) and procedures performed by anesthesiologists (e.g., epidural steroid injections, facet joint blocks). Subjects completed measures of pain severity, depression, disability, and pain-related anxiety, prior to treatment and at a 6-month follow-up. Follow-up assessment also included measures of treatment satisfaction and characteristics of the patient's clinic experience and a chart review to assess medications, procedures, and number of visits. Comparison of baseline and follow-up data showed statistically significant reductions in pain (25%) and depression. Most patients were satisfied (45.6%) or extremely satisfied (43.9%) with the treatment they received (10.5% was somewhat satisfied, none were dissatisfied). Correlation analyses showed that patient demographic variables did not predict treatment satisfaction. Changes in pain, depression, and pain-related anxiety were associated with treatment satisfaction but change in pain was a relatively weak predictor. Nine of the 16 characteristics of the patient's clinic experience correlated with treatment satisfaction. Regression analyses showed that the strongest unique predictors of treatment satisfaction were the patients feeling their evaluation was complete, believing they received an explanation for clinic procedures, and finding that treatment helped them improve their daily activity.
治疗满意度是疼痛管理中越来越受欢迎的一种结果指标。虽然它是一个主观变量,但仍可能反映护理质量,并且可能预测其他重要的患者行为。本研究的目的是前瞻性评估慢性疼痛治疗满意度的预测因素。研究对象包括62名在社区专科诊所寻求疼痛治疗的成年人。治疗包括止痛药物(如阿片类药物、三环类抗抑郁药)的联合使用以及麻醉医生实施的操作(如硬膜外类固醇注射、小关节阻滞)。研究对象在治疗前和6个月随访时完成了疼痛严重程度、抑郁、残疾以及疼痛相关焦虑的测量。随访评估还包括治疗满意度测量、患者诊所体验特征以及病历审查,以评估用药、操作和就诊次数。基线数据与随访数据的比较显示,疼痛(25%)和抑郁有统计学意义的降低。大多数患者对所接受的治疗感到满意(45.6%)或极其满意(43.9%)(10.5%有点满意,无人不满意)。相关分析表明,患者人口统计学变量不能预测治疗满意度。疼痛、抑郁和疼痛相关焦虑的变化与治疗满意度相关,但疼痛变化是一个相对较弱的预测因素。患者诊所体验的16项特征中有9项与治疗满意度相关。回归分析表明,治疗满意度最强的独立预测因素是患者感觉评估完整、认为对诊所操作得到了解释以及发现治疗有助于他们改善日常活动。