Lapane Kate L, Quilliam Brian J, Benson Carmela, Chow Wing, Kim Myoung
Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA.
J Pain Symptom Manage. 2014 Feb;47(2):325-33. doi: 10.1016/j.jpainsymman.2013.03.023. Epub 2013 Jul 20.
Either a two-factor representation (pain intensity and interference) or a three-factor representation (pain intensity, activity interference, and affective interference) of the modified Brief Pain Inventory (BPI) is appropriate among cancer patients.
To evaluate the extent to which a three-factor representation (pain intensity, activity interference, and affective interference) is appropriate for BPI among patients with noncancer pain seen in an outpatient setting.
We conducted a prospective, multicenter, observational, nonrandomized study using patient pain registry data from outpatient settings. Seven hundred forty-one patients with acute episodes of noncancer pain requiring treatment with a prescription medication containing oxycodone immediate-release on an as-needed basis for at least five days participated. Baseline measurements included the modified BPI pain intensity (right now, average, and worst in 24 hours) and pain interference with general activities, walking, work, mood, relations with others, sleep, and life enjoyment. Confirmatory factor analysis was conducted for the overall sample and among postoperative patients (n = 133), patients with back and neck pain (n = 202), patients with arthritis (n = 148), and patients with injury or trauma (n = 204).
Both the two-factor and three-factor models were statistically better than the one-factor model (P < 0.05), with the two-factor model performing better than the three-factor model. Configural invariance, but not metric invariance by patient cohort group was demonstrated.
Consistent with analyses among cancer patients, a two-factor representation of BPI is appropriate for noncancer patients seen in an ambulatory setting. This work lends additional support for the psychometric properties of BPI.
改良简短疼痛量表（BPI）的双因素表示法（疼痛强度和干扰）或三因素表示法（疼痛强度、活动干扰和情感干扰）在癌症患者中均适用。
评估三因素表示法（疼痛强度、活动干扰和情感干扰）在门诊非癌性疼痛患者中对BPI的适用程度。
我们利用门诊患者疼痛登记数据进行了一项前瞻性、多中心、观察性、非随机研究。741例需要按需使用含速释羟考酮的处方药治疗至少5天的非癌性疼痛急性发作患者参与了研究。基线测量包括改良BPI疼痛强度（此刻、平均和24小时内最严重）以及疼痛对一般活动、行走、工作、情绪、与他人关系、睡眠和生活乐趣的干扰。对整个样本以及术后患者（n = 133）、颈肩痛患者（n = 202）、关节炎患者（n = 148）和损伤或创伤患者（n = 204）进行了验证性因素分析。
双因素模型和三因素模型在统计学上均优于单因素模型（P < 0.05），双因素模型的表现优于三因素模型。证明了构型不变性，但患者队列组的度量不变性未得到证明。
与癌症患者的分析结果一致，BPI的双因素表示法适用于门诊非癌性疼痛患者。这项工作为BPI的心理测量特性提供了额外支持。
