Raak Ragnhild, Wallin Mia
Department of Social and Welfare Studies, University of Linköping, Campus Norrköping, Dragsgatan 7, SE-601 74 Norrköping, Sweden.
Biol Res Nurs. 2006 Oct;8(2):138-46. doi: 10.1177/1099800406291078.
Thermal sensitivity, thermal pain thresholds, and catastrophizing were examined in individuals with whiplash associated disorders (WAD) and in healthy pain-free participants. Quantitative sensory testing (QST) was used to measure skin sensitivity to cold and warmth and cold and heat pain thresholds over both the thenar eminence and the trapezius muscle (TrM) in 17 participants with WAD (age 50.8 +/- 11.3 years) and 18 healthy participants (age 44.8 +/- 10.2 years). The Pain Catastrophizing Scale (PCS) was used to determine pain coping strategies, and visual analogue scales were used for self-assessment of current background pain in individuals in the WAD group as well as experienced pain intensity and unpleasantness after QST and sleep quality in all participants. There were significant differences in warmth threshold and cold and heat pain thresholds of the TrM site between the WAD and pain-free groups. Significant differences between the two groups were also found for the catastrophizing dimension of helplessness in the PCS and in self-assessed quality of sleep. A correlational analysis showed that current background pain is significantly correlated with both cold discrimination and cold pain threshold in the skin over the TrM in individuals with WAD. These findings imply that thermal sensitivity is an important factor to consider in providing nursing care to individuals with WAD. Because biopsychosocial factors also influence the experience of pain in individuals with WAD, the role of nurses includes not only the description of the pain phenomenon but also the identification of relieving and aggravating factors.
对患有挥鞭样损伤相关疾病（WAD）的个体以及无疼痛的健康参与者进行了热敏感性、热痛阈值和灾难化思维的研究。采用定量感觉测试（QST）来测量17名WAD患者（年龄50.8±11.3岁）和18名健康参与者（年龄44.8±10.2岁）的鱼际肌和斜方肌（TrM）部位皮肤对冷、热的敏感性以及冷、热痛阈值。使用疼痛灾难化量表（PCS）来确定疼痛应对策略，并使用视觉模拟量表对WAD组个体当前的背景疼痛、所有参与者在QST后的疼痛强度和不愉快程度以及睡眠质量进行自我评估。WAD组和无疼痛组之间TrM部位的热阈值以及冷、热痛阈值存在显著差异。两组在PCS中无助感的灾难化维度以及自我评估的睡眠质量方面也存在显著差异。相关性分析表明，WAD个体TrM部位皮肤的冷觉辨别和冷痛阈值与当前背景疼痛显著相关。这些发现表明，热敏感性是为WAD个体提供护理时需要考虑的一个重要因素。由于生物心理社会因素也会影响WAD个体的疼痛体验，护士的作用不仅包括描述疼痛现象，还包括识别缓解和加重疼痛的因素。
