Moseley Lorimer
Department of Physiotherapy, The University of Queensland and Royal Brisbane Hospital, Herston, Australia.
J Pain. 2003 May;4(4):184-9. doi: 10.1016/s1526-5900(03)00488-7.
To identify why reconceptualization of the problem is difficult in chronic pain, this study aimed to evaluate whether (1) health professionals and patients can understand currently accurate information about the neurophysiology of pain and (2) health professionals accurately estimate the ability of patients to understand the neurophysiology of pain. Knowledge tests were completed by 276 patients with chronic pain and 288 professionals either before (untrained) or after (trained) education about the neurophysiology of pain. Professionals estimated typical patient performance on the test. Untrained participants performed poorly (mean +/- standard deviation, 55% +/- 19% and 29% +/- 12% for professionals and patients, respectively), compared to their trained counterparts (78% +/- 21% and 61% +/- 19%, respectively). The estimated patient score (46% +/- 18%) was less than the actual patient score (P <.005). The results suggest that professionals and patients can understand the neurophysiology of pain but professionals underestimate patients' ability to understand. The implications are that (1) a poor knowledge of currently accurate information about pain and (2) the underestimation of patients' ability to understand currently accurate information about pain represent barriers to reconceptualization of the problem in chronic pain within the clinical and lay arenas.
为了确定在慢性疼痛中重新认识问题为何困难，本研究旨在评估：（1）医疗专业人员和患者是否能够理解当前关于疼痛神经生理学的准确信息；（2）医疗专业人员是否准确估计了患者理解疼痛神经生理学的能力。276名慢性疼痛患者和288名专业人员在接受关于疼痛神经生理学的教育之前（未培训）或之后（培训后）完成了知识测试。专业人员估计了患者在测试中的典型表现。与接受培训后的参与者（分别为78%±21%和61%±19%）相比，未接受培训的参与者表现较差（专业人员和患者分别为55%±19%和29%±12%）。估计的患者得分（46%±18%）低于实际患者得分（P<.005）。结果表明，专业人员和患者能够理解疼痛的神经生理学，但专业人员低估了患者的理解能力。这意味着：（1）对当前关于疼痛的准确信息了解不足；（2）低估患者理解当前关于疼痛的准确信息的能力，这些是临床和普通人群中重新认识慢性疼痛问题的障碍。
