Gagliese Lucia, Melzack Ronald
School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3 Canada Department of Anesthesia and Pain Management, University Health Network, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4 Canada Department of Anesthesia, University of Toronto, Fitzgerald Building Rm. 131, 150 College Street, Toronto, Ontario, M5S 3E2 Canada Department of Psychology, McGill University, Montreal, Quebec, Canada.
Pain. 2003 Aug;104(3):597-608. doi: 10.1016/S0304-3959(03)00117-9.
Age differences in the experience of chronic pain remain unclear. A serious barrier to progress in the field of pain and aging arises from the lack of data regarding the psychometric properties of pain scales for use with the elderly. The present study was designed to assess age differences in pain intensity and quality and to compare the psychometric properties of the McGill Pain Questionnaire (MPQ) in young and elderly chronic pain patients. Young (n=139, mean age=42.93+/-9.41 years) and elderly (n=139, mean age=70.12+/-7.51 years) pain center patients, matched on primary diagnosis or pain location, duration, and sex, completed the MPQ, numeric ratings (0-10) of pain intensity, a Pain Map, and the Hospital Anxiety and Depression Scale (HADS). A Pain Management Index (PMI) score was calculated for each patient. Age differences on the measure of pain qualities were found. The elderly group had significantly lower MPQ total and sensory scores and chose fewer words than the young group. However, there were no significant differences between the groups on numeric ratings of highest, usual, and lowest pain intensity. Similarly, there were no age differences on PMI, Pain Map, or the HADS Depression or Anxiety Subscales. Finally, the latent structure, internal consistency, and pattern of subscale correlations of the MPQ were very similar in the young and elderly groups. Possible explanations for the discrepancy in the pattern of age differences on measures of pain intensity and quality are explored. The implications of this pattern of age differences for basic pain mechanisms and pain management should be given serious empirical attention.
慢性疼痛体验中的年龄差异仍不明确。疼痛与衰老领域进展的一个严重障碍源于缺乏关于适用于老年人的疼痛量表心理测量特性的数据。本研究旨在评估年轻和老年慢性疼痛患者在疼痛强度和性质方面的年龄差异，并比较麦吉尔疼痛问卷（MPQ）的心理测量特性。根据主要诊断、疼痛部位、持续时间和性别匹配的年轻（n = 139，平均年龄 = 42.93 ± 9.41岁）和老年（n = 139，平均年龄 = 70.12 ± 7.51岁）疼痛中心患者完成了MPQ、疼痛强度的数字评分（0 - 10）、疼痛地图以及医院焦虑抑郁量表（HADS）。为每位患者计算疼痛管理指数（PMI）得分。发现了疼痛性质测量方面的年龄差异。老年组的MPQ总分和感觉分数显著低于年轻组，且选择的词汇比年轻组少。然而，两组在最高、通常和最低疼痛强度的数字评分上没有显著差异。同样，在PMI、疼痛地图或HADS抑郁或焦虑子量表上也没有年龄差异。最后，MPQ的潜在结构、内部一致性和子量表相关性模式在年轻组和老年组中非常相似。探讨了疼痛强度和性质测量中年龄差异模式存在差异的可能原因。这种年龄差异模式对基本疼痛机制和疼痛管理的影响应得到认真的实证关注。
