University of Rochester, School of Nursing & Department of Biomedical Engineering, Rochester, NY 14642, USA.
Clin J Pain. 2010 Oct;26(8):667-76. doi: 10.1097/AJP.0b013e3181e72507.
Pain assessment conventionally has been viewed hierarchically with self-report as its "gold-standard." Recent attempts to improve pain management have focused on the importance of assessment, for example, the initiative to include pain as the "fifth vital sign." We question the focus in the conceptualization of pain assessment upon a "vital sign," not in terms of the importance of assessment, but in terms of the application of self-report as a mechanistic index akin to a biologic measure such as heart rate and blood pressure. We synthesize current inclusive models of pain and pain assessment and propose a more comprehensive conceptualization of pain assessment as a transaction based on an organismic interplay between the patient and clinician.
疼痛评估传统上是按照等级顺序进行的，自我报告是其“金标准”。最近，人们试图通过提高评估的重要性来改善疼痛管理，例如，将疼痛作为“第五大生命体征”纳入其中。我们质疑将疼痛评估的概念集中在“生命体征”上，这不是因为评估的重要性，而是因为自我报告作为一种类似于心率和血压等生物学测量的机械指标的应用。我们综合了当前的疼痛和疼痛评估综合模型，并提出了一个更全面的疼痛评估概念，即一种基于患者和临床医生之间的机体相互作用的交易。
