Cedraschi C, Allaz A F
Multidisciplinary Pain Centre, Service of Clinical Pharmacology and Toxicology and Division of General Medical Rehabilitation, Geneva University Hospitals, 1211 Geneva 14, Switzerland.
Best Pract Res Clin Rheumatol. 2005 Aug;19(4):577-91. doi: 10.1016/j.berh.2005.03.002.
Predicting poor outcomes in daily practice is challenging. As well as prior episodes of low back pain and pain intensity, various psychosocial risk factors have been identified, although the independent prognostic value of these is rather low. This supports the necessity for a multidimensional view of the transition from acute to chronic pain and/or the development of disability. Psychological distress has been found to increase the risk of such a transition. Patients' beliefs and expectations about their pain seem to influence the recovery process; pain-related fear and fear avoidance can be influential psychological variables, from pain inception to its chronic stage. The influence of occupational factors such as job satisfaction, low workplace support or physical workload has also been emphasized. Treatment provider factors and the relationship between patients and care providers also contribute to the realistic or unrealistic expectations and meaningful or acceptable outcomes.
在日常实践中预测不良预后具有挑战性。除了既往的腰痛发作和疼痛强度外，还确定了各种社会心理风险因素，尽管这些因素的独立预后价值相当低。这支持了从多维视角看待从急性疼痛到慢性疼痛的转变和/或残疾发展的必要性。已发现心理困扰会增加这种转变的风险。患者对其疼痛的信念和期望似乎会影响康复过程；从疼痛开始到慢性阶段，与疼痛相关的恐惧和恐惧回避可能是有影响力的心理变量。职业因素如工作满意度、低工作场所支持或体力工作量的影响也得到了强调。治疗提供者因素以及患者与护理提供者之间的关系也会导致现实或不现实的期望以及有意义或可接受的结果。
