Walker Sarah, Hopman Wilma M, Harrison Margaret B, Tripp Dean, VanDenKerkhof Elizabeth G
Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston ON; School of Nursing, Queen's University, Kingston ON.
Clinical Research Centre, Kingston General Hospital, Kingston ON; Department of Community Health and Epidemiology, Kingston ON.
J Obstet Gynaecol Can. 2012 Jun;34(6):543-551. doi: 10.1016/S1701-2163(16)35270-7.
Pain is frequently a complaint prior to gynaecological surgery. Psychological factors are also known to influence the experience of pain. The primary objective of this study was to assess the prevalence of pain and the relationship between psychological factors and pain in women awaiting gynaecological surgery.
Four hundred twenty-nine women in a tertiary care centre in southeastern Ontario were included in this cross-sectional analysis, which was embedded in a larger prospective study. Pain was assessed using the Brief Pain Inventory, anxiety using the State Trait Anxiety Inventory, depressive symptoms using the Center for Epidemiologic Studies Depression Scale, somatization using the Seven Symptom Screening Test, and catastrophizing with an abbreviated coping strategies questionnaire.
Eighteen percent of women reported high anxiety, 37% reported depressive symptoms, 47% had two or more symptoms of somatization, and 40% reported elevated pain catastrophizing. Approximately one third reported moderate to severe pain intensity and interference. Of those reporting pain, 81% believed their pain was due to their primary condition. Depressive symptoms, somatization, and catastrophizing were associated with elevated pain intensity and interference.
The responses suggest a substantial burden of pain, anxiety, and depressive symptoms in women awaiting gynaecological surgery. Further research is needed to assess the management of these symptoms and their impact on health care resources and the well-being of women in this setting.
疼痛常常是妇科手术前的一个主诉。心理因素也被认为会影响疼痛体验。本研究的主要目的是评估等待妇科手术的女性中疼痛的患病率以及心理因素与疼痛之间的关系。
安大略省东南部一家三级护理中心的429名女性纳入了这项横断面分析,该分析是一项更大的前瞻性研究的一部分。使用简明疼痛量表评估疼痛,使用状态特质焦虑量表评估焦虑,使用流行病学研究中心抑郁量表评估抑郁症状,使用七症状筛查测试评估躯体化,并用简化应对策略问卷评估灾难化思维。
18%的女性报告有高度焦虑,37%报告有抑郁症状,47%有两种或更多躯体化症状,40%报告有较高的疼痛灾难化思维。约三分之一的女性报告有中度至重度疼痛强度和疼痛干扰。在报告疼痛的女性中,81%认为她们的疼痛是由其原发性疾病引起的。抑郁症状、躯体化和灾难化思维与更高的疼痛强度和疼痛干扰相关。
这些反应表明,等待妇科手术的女性存在相当大的疼痛、焦虑和抑郁症状负担。需要进一步研究来评估这些症状的管理及其对医疗资源和该环境下女性健康的影响。