Thienthong Somboon, Pratheepawanit Nutjaree, Limwattananon Chulaporn, Maoleekoonpairoj Savitree, Lertsanguansinchai Prasert, Chanvej Laksamee
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Thailand.
J Med Assoc Thai. 2006 Aug;89(8):1120-6.
To identify the association between Quality Of Life (QOL) and pain intensity, and the magnitude of change of pain scores that have a clinically significant impact on patients' QOL.
Multi-center; prospective cohort study.
Patients suffering from cancer pain were recruited from seven university hospitals and three tertiary care centers in Thailand. The FACT-G and the Brief Pain Inventory were used to assess QOL and cancer pain severity, respectively, at study entry and at two-week follow-up.
Five-hundred-and-twenty patients were recruited with a mean age of 52. The majority (76%) reported two sites of pain with 80% being treated at either step 2 or 3 (WHO guidelines of pain management). After two weeks, the average level of maximum pain was reduced from 6.6 to 4.8 (mean difference = -1.8, p < 0.001) and the QOL was improved from 58.6 to 61.0 (mean difference = 2.4, p < 0.001). There was a high correlation between the average change of pain intensity and QOL scores (rs = -0.42, p < 0.001). The results show that changes of pain scores of at least three points (3 out of 10) were required for a minimal important difference of FACT-G scores, indicating a significant change on patients' QOL. Pain deterioration had slightly more impact on QOL than pain improvement. A 3-point pain deterioration impaired QOL 10.3 points while 3-point reduction increased QOL only 7.6 points.
The present findings suggest the importance of pain management. The change of pain scores of at least three points (out of 10 points) had statistical and clinical significance to patients' QOL.
确定生活质量（QOL）与疼痛强度之间的关联，以及对患者生活质量有临床显著影响的疼痛评分变化幅度。
多中心；前瞻性队列研究。
从泰国的七所大学医院和三个三级护理中心招募癌症疼痛患者。在研究开始时和两周随访时，分别使用FACT - G和简明疼痛量表评估生活质量和癌症疼痛严重程度。
招募了520名患者，平均年龄为52岁。大多数（76%）报告有两个疼痛部位，80%的患者接受了WHO疼痛管理指南中第2步或第3步的治疗。两周后，最大疼痛的平均水平从6.6降至4.8（平均差异=-1.8，p<0.001），生活质量从58.6提高到61.0（平均差异=2.4，p<0.001）。疼痛强度的平均变化与生活质量评分之间存在高度相关性（rs=-0.42，p<0.001）。结果表明，FACT - G评分的最小重要差异要求疼痛评分至少改变三分（满分10分中的3分），这表明患者的生活质量有显著变化。疼痛恶化对生活质量的影响略大于疼痛改善。疼痛评分恶化3分使生活质量受损10.3分，而疼痛评分降低3分仅使生活质量提高7.6分。
目前的研究结果表明疼痛管理的重要性。疼痛评分至少改变三分（满分10分）对患者的生活质量具有统计学和临床意义。
