Division of Anesthesia and Intensive Care, Soroka University Medical Center, Beer-Sheva, Israel.
Pain Med. 2010 Mar;11(3):446-52. doi: 10.1111/j.1526-4637.2009.00795.x. Epub 2010 Jan 22.
To examine the predictive value of physician's prognosis after patient's first visit to a pain specialty clinic.
This is a prospective-longitudinal study in which patients completed questionnaires regarding their pain and psychological constructs before their first visit to a pain specialist and again after an average of 5 months. Physicians rated patient's prognosis immediately after the first visit.
This study was conducted at the outpatient specialty pain clinic at Soroka University Medical Center.
Forty-five chronic pain patients suffering from a range of nonmalignant pain conditions.
Sensory and affective pain measured by the Short-Form McGill Pain Questionnaire and depressive symptoms measured by the Center for Epidemiological Studies-Depression Scale.
Multiple regression analysis revealed that physician's rating of patient prognosis at Time 1 uniquely predicted subsequent depressive symptoms and affective pain but not sensory pain at Time 2 even after controlling for Time 1 levels of these variables.
Physician's pessimistic evaluation of patient's prognosis after the first visit was longitudinally associated with an increase in depression and in the affective dimension of pain over time, but not with changes in the sensory component of pain. Referring to physician pessimism as a marker for pre-depressed patient may lead to early preventive interventions.
探讨医生在患者首次就诊疼痛专科门诊后对其预后的预测价值。
这是一项前瞻性纵向研究，患者在首次就诊疼痛专家前和平均 5 个月后再次完成关于疼痛和心理结构的问卷。医生在首次就诊后立即对患者的预后进行评估。
本研究在索罗卡大学医学中心的门诊专科疼痛诊所进行。
45 名患有各种非恶性疼痛疾病的慢性疼痛患者。
用简短 McGill 疼痛问卷测量感觉和情感疼痛，用流行病学研究中心抑郁量表测量抑郁症状。
多元回归分析显示，医生在第 1 次就诊时对患者预后的评估，在控制第 1 次就诊时这些变量的水平后，可独立预测第 2 次就诊时的抑郁症状和情感疼痛，但不能预测感觉疼痛。
医生在首次就诊后对患者预后的悲观评估，与随时间推移抑郁和疼痛的情感维度的增加有关，但与疼痛的感觉成分的变化无关。将医生的悲观主义视为抑郁患者的标志物，可能会导致早期预防干预。
