Waddell G, Richardson J
West of Scotland Back Pain Research Unit, Orthopaedic Department, Western Infirmary, Glasgow, U.K.
J Psychosom Res. 1992 Jan;36(1):77-87. doi: 10.1016/0022-3999(92)90116-j.
Observation of overt pain behaviours was carried out by physicians during routine clinical examination of 120 patients with chronic low back pain. Reliable ratings were achieved but only after very careful standardization in an additional 60 pilot patients. Overt pain behaviour was found to be related to other clinical measures of illness behaviour--pain drawing, behavioural symptoms, behavioural signs, use of walking aides and downtime--but did tap an additional dimension. It is concluded that clinical observation of overt pain behaviour can provide useful additional information about illness behaviour in low back pain. Reliable observations can be achieved in a carefully standardized research situation but in routine clinical practice are vulnerable to considerable observer error and bias.
在对120例慢性下背痛患者进行常规临床检查期间，医生对明显的疼痛行为进行了观察。只有在对另外60例试点患者进行非常仔细的标准化之后，才获得了可靠的评分。发现明显的疼痛行为与疾病行为的其他临床指标——疼痛绘图、行为症状、行为体征、助行器使用情况和停工时间——有关，但确实反映了一个额外的维度。得出的结论是，对明显疼痛行为的临床观察可以提供有关下背痛疾病行为的有用额外信息。在精心标准化的研究环境中可以获得可靠的观察结果，但在常规临床实践中容易出现相当大的观察者误差和偏差。
