Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta T2N 4N2, Canada.
J Pain Symptom Manage. 2010 Feb;39(2):230-40. doi: 10.1016/j.jpainsymman.2009.07.006.
Bone metastases are prevalent, painful, and carry a poorer prognosis for pain control compared with other cancer pain syndromes. Standard tools to measure pain have not been validated in this patient population, and particular subgroups with more challenging symptoms have yet to be identified and studied. The objectives of this study were 1) to validate the psychometric properties of the Brief Pain Inventory (BPI) and its Pain and Interference subscales in patients with clinically significant metastatic bone pain requiring palliative radiotherapy and 2) to examine differences in BPI subscales among predefined subgroups of bone metastases patients. A total of 258 patients evaluated and treated through a rapid access radiation therapy clinic between July 2002, and November 2006, were included in the analysis. High internal consistency of the BPI subscales of Pain, Activity interference, and Affect interference was demonstrated by Cronbach's alpha between 0.81 and 0.89. Removing sleep interference improved model fit in confirmatory factor analysis. The BPI revealed an alarming pattern in patients with lower body metastases, who reported substantial interference of activity even though pain levels were mild or moderate. Such patients may require prompt clinical attention to better meet their needs. Finally, the allocation of interference from sleep within the BPI framework, in our population of pain patients, requires further study.
骨转移是常见的，疼痛的，并伴有较差的预后疼痛控制与其他癌症疼痛综合征相比。标准的疼痛测量工具尚未在这一患者群体中得到验证，而且具有更具挑战性症状的特定亚组尚未得到确定和研究。本研究的目的是 1）验证简明疼痛量表（BPI）及其疼痛和干扰子量表在需要姑息性放疗的有临床意义的转移性骨痛患者中的心理测量特性，2）检查 BPI 子量表在骨转移患者的预定义亚组中的差异。共有 258 例患者于 2002 年 7 月至 2006 年 11 月通过快速通道放疗诊所进行评估和治疗，被纳入分析。BPI 的疼痛、活动干扰和情感干扰子量表的内部一致性较高，Cronbach 的 alpha 值在 0.81 到 0.89 之间。在验证性因子分析中，去除睡眠干扰可改善模型拟合。BPI 显示出下半身转移患者令人担忧的模式，他们报告说即使疼痛程度为轻度或中度，活动也会受到很大干扰。这些患者可能需要及时的临床关注，以更好地满足他们的需求。最后，在我们的疼痛患者群体中，睡眠干扰在 BPI 框架内的分配需要进一步研究。
