Bentsen Signe Berit, Hanestad Berit Rokne, Rustøen Tone, Wahl Astrid Klopstad
Department of Nursing Education, Stord/Haugesund University College, Bergen, Norway.
J Clin Nurs. 2008 Aug;17(15):2061-9. doi: 10.1111/j.1365-2702.2008.02232.x.
The aim of this study was to examine pain and quality of life in a group of preoperative chronic low back pain patients (n = 25) and a group of postoperative chronic low back pain patients (n = 101) treated with instrumented fusion 1-8 years ago.
Reduced quality of life is common in chronic low back pain patients and the aim of treatment is to improve quality of life.
In the present study, a comparative survey design was used.
The McGill Pain Questionnaire and the SF-36 Health Survey were used to examine pain and quality of life.
The pre- and postoperative groups did not differ with regard to age, gender, education, other chronic conditions or previous spinal surgery. Compared with the preoperative group, the postoperative group reported significantly lower total, sensory, affective and evaluative pain, used less pain medication (p < 0.05) and reported better scores in all SF-36 components (p < 0.05), except for general health. The effect size was > or =0.8 for all pain components and > or =0.4 for all SF-36 components, except for general health (effect size = 0.009). With regard to long-term follow-up, patients who underwent surgery 5-8 years ago reported better physical role functioning (p < 0.05) compared with those who underwent surgery 1-2 years ago.
Results showed that the postoperative group reported significantly less pain and better physical and mental health compared with the preoperative group. However, despite surgery, the postoperative group reported suffering from pain and reduced quality of life. Relevance to clinical practice. Psychosocial interventions focusing on psychosocial consequences of pain are needed to modify the pain experience and increase the quality of life in patients who have undergone this kind of surgery.
本研究旨在调查一组术前慢性下腰痛患者(n = 25)和一组1 - 8年前接受器械融合术治疗的术后慢性下腰痛患者(n = 101)的疼痛情况及生活质量。
慢性下腰痛患者生活质量下降很常见,治疗目的是提高生活质量。
本研究采用比较性调查设计。
使用麦吉尔疼痛问卷和SF - 36健康调查来评估疼痛和生活质量。
术前组和术后组在年龄、性别、教育程度、其他慢性疾病或既往脊柱手术方面无差异。与术前组相比,术后组报告的总疼痛、感觉性疼痛、情感性疼痛和评价性疼痛显著更低,使用的止痛药物更少(p < 0.05),并且除总体健康外,在所有SF - 36量表项目上得分更高(p < 0.05)。所有疼痛项目的效应量≥0.8,除总体健康外(效应量 = 0.009),所有SF - 36量表项目的效应量≥0.4。关于长期随访,与1 - 2年前接受手术的患者相比,5 - 8年前接受手术的患者在身体角色功能方面报告更好(p < 0.05)。
结果表明,与术前组相比,术后组报告的疼痛显著减轻,身心健康状况更好。然而,尽管接受了手术,术后组仍报告有疼痛和生活质量下降的情况。与临床实践的相关性:需要针对疼痛的心理社会后果进行心理社会干预,以改变疼痛体验并提高接受此类手术患者的生活质量。