Rheumatology Department, Polytechnic University of Marche, Ancona, Italy.
Clin Exp Rheumatol. 2009 Sep-Oct;27(5 Suppl 56):S92-105.
A comprehensive assessment of the multiple symptom domains associated with fibromyalgia (FM) and the impact of FM on multidimensional aspects of function should form a routine part of the care of FM patients. Clinical trials and long-term clinical registries have used various outcome measures, but the key domains include pain, fatigue, disturbed sleep, physical functioning, emotional functioning, patient global ratings of satisfaction, and their health-related quality of life (HRQL). A number of measures have been ''borrowed'' from the fields of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and adapted to FM, and others are being developed specifically for FM. However, despite the burgeoning theoretical literature and the proliferation of instruments for measuring various health status domains, no unified approach has been developed and there is little agreement concerning the meaning of the results. There is, therefore, still a need for further consensus and the development of a core set of measures and response criteria, more refined measuring instruments, standardised assessor training, cross-cultural adaptations of health status questionnaires, electronic data capture, and the introduction of standardised quantitative measurements into routine clinical care. This article discusses the advantages and limitations of a selection of both newly developed and well-established and validated distress screening instruments that underlines the continuing challenge of assessing FM.
对纤维肌痛（FM）相关的多种症状领域进行全面评估，以及 FM 对功能的多个维度的影响，应成为 FM 患者护理的常规内容。临床试验和长期临床登记处使用了各种结局测量指标，但关键领域包括疼痛、疲劳、睡眠障碍、身体功能、情绪功能、患者对满意度的总体评价，以及他们的健康相关生活质量（HRQL）。一些措施已经从类风湿关节炎、银屑病关节炎、强直性脊柱炎等领域“借用”，并适应 FM，还有一些则是专门为 FM 开发的。然而，尽管理论文献不断涌现，用于测量各种健康状况领域的工具也在不断增多，但尚未制定出统一的方法，对于结果的含义也几乎没有达成共识。因此，仍需要进一步达成共识，制定核心的一套测量指标和反应标准，更精细的测量工具，标准化的评估者培训，健康状况问卷的跨文化适应性，电子数据采集，以及将标准化的定量测量引入常规临床护理。本文讨论了一系列新开发的和经过良好验证的痛苦筛选工具的优缺点，强调了评估 FM 的持续挑战。
