Barber Matthew D, Janz Nancy, Kenton Kim, Hsu Yvonne, Greer W Jerod, Dyer Keisha, White Amanda, Meikle Susan, Ye Wen
Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Female Pelvic Med Reconstr Surg. 2012 Jul-Aug;18(4):198-204. doi: 10.1097/SPV.0b013e31825d65aa.
Surgical pain scales (SPS) consist of 4 items that measure pain at rest, during normal activities, and during work/exercise and quantify unpleasantness of worst pain, which are valid and responsive in men undergoing hernia repair. Our objective was to evaluate the psychometric properties of SPS in women undergoing vaginal surgery for pelvic organ prolapse and stress urinary incontinence.
We modified SPS by converting original response scales from a visual analog scale to numerical rating scales. Numerical rating scales have lower error rates and higher validity than visual analog scale. The sample included 169 women with stage II to IV pelvic organ prolapse and stress urinary incontinence in a randomized trial comparing sacrospinous ligament fixation to uterosacral vault suspension with and without pelvic floor muscle training. Participants completed SPS and SF-36 at baseline, and 2 weeks and 6 months after surgery. Construct validity and responsiveness were examined in cross-sectional and longitudinal data using Pearson correlation and analysis of variance.
Pain at rest, during normal activities, and during work/exercise worsened at 2 weeks (P<0.05); and all measures of pain improved from baseline to 6 months (P<0.0001). Construct validity was demonstrated by correlations of 0.51 to 0.74 between SPS and the SF-36 Bodily Pain Scale (P<0.0001). Pain worsened on SF-36 between baseline and 2 weeks in 63% of the participants, and this group demonstrated a mean (SD) increase in pain of 1.9 (2.8) on the SPS (effect size, 0.99), confirming responsiveness of the scale.
The modified SPS are valid and responsive in women after pelvic reconstructive surgery.
手术疼痛量表（SPS）由4个项目组成，用于测量静息时、正常活动期间、工作/锻炼期间的疼痛，并对最严重疼痛的不适感进行量化，该量表在接受疝气修补术的男性中具有有效性和反应性。我们的目的是评估SPS在接受盆腔器官脱垂和压力性尿失禁阴道手术的女性中的心理测量特性。
我们对SPS进行了修改，将原始反应量表从视觉模拟量表转换为数字评分量表。数字评分量表比视觉模拟量表具有更低的错误率和更高的有效性。样本包括169名患有II至IV期盆腔器官脱垂和压力性尿失禁的女性，她们参与了一项随机试验，该试验比较了骶棘韧带固定术与子宫骶骨穹窿悬吊术加或不加盆底肌肉训练的效果。参与者在基线、术后2周和6个月时完成SPS和SF-36问卷。使用Pearson相关性分析和方差分析在横断面和纵向数据中检查结构效度和反应性。
静息时、正常活动期间和工作/锻炼期间的疼痛在术后2周时加重（P<0.05）；所有疼痛指标从基线到6个月时均有所改善（P<0.0001）。SPS与SF-36身体疼痛量表之间的相关性为0.5至0.74，证明了结构效度（P<0.0001）。63%的参与者在基线至术后2周期间SF-36上的疼痛加重，该组在SPS上的疼痛平均（标准差）增加了1.9（2.8）（效应大小为0.99），证实了该量表的反应性。
改良后的SPS在盆腔重建术后的女性中具有有效性和反应性。
