Department of Neurology & Psychiatry, Saint Louis University School of Medicine, 1438 South Grand Boulevard, St. Louis, MO 63104, USA.
J Behav Med. 2011 Jun;34(3):218-24. doi: 10.1007/s10865-010-9302-8. Epub 2010 Nov 16.
While considerable evidence indicates that the assessment of pain is an exercise in social cognition, provider contributions to pain assessment have received little attention. This study compared internist versus neurosurgeon ratings of pain and pain-related disability for hypothetical patients reporting either low or high levels of low back pain. Using practice characteristics as covariates, a multivariate analysis of covariance showed that both physician groups rated pain severity, but not measures of disability, as significantly lower for the low pain severity condition. Relative to internists, neurosurgeons rated both pain severity and pain-related disability as significantly lower, regardless of patient-reported pain severity. There were no interactions between physician specialty and patient-reported pain severity. Practice characteristics accounted for relatively little variance in ratings. Results are discussed in terms of differences in comparison levels for the physician groups, as well as implications for clinical practice and disability determination systems.
尽管有大量证据表明，疼痛评估是一种社会认知的过程，但提供者在疼痛评估中的贡献却很少受到关注。本研究比较了内科医生和神经外科医生对报告低水平或高水平腰痛的假设患者的疼痛和与疼痛相关的残疾的评估。使用实践特征作为协变量，多变量协方差分析显示，两组医生都认为低疼痛严重程度的情况下疼痛严重程度显著降低，但残疾程度的测量指标则不然。与内科医生相比，神经外科医生无论患者报告的疼痛严重程度如何，都认为疼痛严重程度和与疼痛相关的残疾程度显著降低。医生专业和患者报告的疼痛严重程度之间没有相互作用。实践特征在评分中的差异相对较小。结果从医生群体的比较水平差异以及对临床实践和残疾确定系统的影响方面进行了讨论。
