Haynsworth Robert F, Clark Timothy, Noe Carl E, Holmes Jennifer, Havemann Eric
Department of Anesthesiology and Pain Management, Baylor University Medical Center, Dallas, Texas, USA.
Proc (Bayl Univ Med Cent). 2002 Jan;15(1):6-8. doi: 10.1080/08998280.2002.11927804.
The purpose of this study was to determine whether an exaggerated response to a mildly painful stimulus would reflect abnormal levels of psychological distress in patients and, conversely, whether patients who show abnormal levels of psychological distress would have a low tolerance for a mildly painful stimulus. A total of 101 patients were given a mildly painful stimulus (30-gauge needle stick) and asked to record the amount of pain they felt on a scale of 0 to 10 (0 = no pain, 10 = severe pain). The mean response to the needle stick was a 1.9 on this scale. There was no gender difference, and the average did not change with increasing age. Psychological testing showed that 18% of the 101 patients had psychological distress prior to the needle stick. The pain ratings to needle stick of these 18 patients were not significantly different than those of patients without psychological distress (2.3 vs 1.9 on the scale). Seven percent of patients had a very low tolerance for pain (pain score of > or = 7). Evaluation of the psychological testing results on these patients showed no significant difference compared with known normal psychological values. Therefore, the assumption that patients who over-respond to a mildly painful stimulus have psychological distress is not valid. The results of this study suggest only that patients who over-respond to a needle stick have a low tolerance for pain. Furthermore, it is not valid to assume that patients who have psychological distress, poor coping abilities, or marked stress will respond in an exaggerated fashion to a mildly painful stimulus.
本研究的目的是确定对轻度疼痛刺激的过度反应是否反映患者心理困扰水平异常，反之，心理困扰水平异常的患者对轻度疼痛刺激的耐受性是否较低。总共101名患者接受了轻度疼痛刺激（30号针头穿刺），并被要求在0至10的量表上记录他们感受到的疼痛程度（0 = 无疼痛，10 = 剧痛）。在该量表上，对针头穿刺的平均反应为1.9。不存在性别差异，且平均值不会随年龄增长而变化。心理测试显示，101名患者中有18%在针头穿刺前存在心理困扰。这18名患者对针头穿刺的疼痛评分与无心理困扰的患者相比无显著差异（量表上分别为2.3和1.9）。7%的患者对疼痛的耐受性极低（疼痛评分≥7）。对这些患者心理测试结果的评估显示，与已知的正常心理值相比无显著差异。因此，认为对轻度疼痛刺激过度反应的患者存在心理困扰这一假设是无效的。本研究结果仅表明，对针头穿刺过度反应的患者对疼痛的耐受性较低。此外，认为有心理困扰、应对能力差或压力显著的患者会对轻度疼痛刺激做出过度反应这一假设也是无效的。
