Zelman Diane C, Gore Mugdha, Dukes Ellen, Tai Kei-Sing, Brandenburg Nancy
California School of Professional Psychology-Alliant International University, San Francisco, CA 94133, USA.
J Vasc Nurs. 2005 Sep;23(3):97-104. doi: 10.1016/j.jvn.2005.06.004.
Neuropathic pain is the focus of current clinical research, clinical identification, and treatment. It is unique from nociceptive pain and requires evaluation of the relevance and utility of common pain measures created for other painful conditions. This study evaluated the psychometric properties of a modified Brief Pain Inventory (BPI) for patients with painful diabetic peripheral neuropathy (BPI-DPN). Participants were patients with painful DPN (n = 255) enrolled in a DPN Burden of Illness survey referred through 17 outpatient settings (primary care physicians, endocrinologists, neurologists, and anesthesiologists). Patients completed the BPI-DPN and self-report measures of health-related quality of life, mood sleep, and health care use. Construct, criterion and discriminant validity, and internal consistency reliability were evaluated. Principal axis factoring with oblimin rotation revealed two interpretable factors (eigenvalues > 1.0), consistent with most published BPI validation studies: a severity scale comprising the four BPI Severity items and an interference scale comprising the seven Interference items, which satisfied criteria for interpretability and model fit. Cronbach's alpha was high (0.94) for both scales. Mean pain Severity was highly correlated with Bodily Pain from the Medical Outcomes Study Short Form-12, version 2 (r(s) = 0.63, P < .001), the Pain/Discomfort item in the Euro-QoL (r(s) = 0.58, P < .001), and a verbal rating scale measure of pain severity (r(s) = 0.74, P < .001). Individual BPI-DPN Interference domains were moderately correlated (r(s)'s > 0.5, P < .001) with analogous measures, and the Sleep Interference item had a high, significant association with the three primary Medical Outcome Study-Sleep scale subscales (r(s)'s = 0.66-71, P < .001). Worst Pain and Interference ratings were significantly associated with hospital use and outpatient visits because of DPN. These results replicate, in a pure peripheral neuropathic pain condition, the BPI psychometric characteristics documented in populations with nociceptive or mixed pain conditions. The BPI-DPN is a promising instrument in the evaluation of painful DPN.
神经病理性疼痛是当前临床研究、临床识别和治疗的重点。它与伤害性疼痛不同，需要评估为其他疼痛状况制定的常见疼痛测量方法的相关性和实用性。本研究评估了改良版简明疼痛量表（BPI）用于疼痛性糖尿病周围神经病变患者（BPI-DPN）的心理测量特性。参与者为通过17个门诊机构（初级保健医生、内分泌学家、神经科医生和麻醉医生）转诊参加糖尿病周围神经病变疾病负担调查的疼痛性糖尿病周围神经病变患者（n = 255）。患者完成了BPI-DPN以及与健康相关的生活质量、情绪、睡眠和医疗保健使用情况的自我报告测量。评估了结构效度、效标效度、区分效度和内部一致性信度。采用斜交旋转的主轴因子分析揭示了两个可解释的因子（特征值>1.0），这与大多数已发表的BPI验证研究一致：一个严重程度量表，由四个BPI严重程度项目组成；一个干扰量表，由七个干扰项目组成，满足可解释性和模型拟合标准。两个量表的Cronbach's α系数都很高（0.94）。平均疼痛严重程度与医学结局研究简明健康调查问卷第2版（SF-12）中的身体疼痛高度相关（r(s)=0.63，P<.001），与欧洲五维度健康量表中的疼痛/不适项目高度相关（r(s)=0.58，P<.001），与疼痛严重程度的言语评定量表高度相关（r(s)=0.74，P<.001）。BPI-DPN各个干扰领域与类似测量方法中度相关（r(s)'s>0.5，P<.001），睡眠干扰项目与医学结局研究睡眠量表的三个主要子量表高度显著相关（r(s)'s= .66 - 71，P<.001）。最严重疼痛和干扰评分与因糖尿病周围神经病变而住院和门诊就诊显著相关。这些结果在单纯的周围神经病理性疼痛情况下，重现了在伤害性或混合性疼痛人群中记录的BPI心理测量特征。BPI-DPN在评估疼痛性糖尿病周围神经病变方面是一种很有前景的工具。
