Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA Nuvo Research, Inc., Pain Group, West Chester, PA, USA.
Pain. 2013 Dec;154(12):2722-2728. doi: 10.1016/j.pain.2013.08.003. Epub 2013 Aug 8.
Patients with low back pain (LBP; N = 102), fibromyalgia (FM; N = 100), and headache (HA; N = 100) were asked to describe their pain in their own words, and the words and phrases they used were then classified into 7 global domains (eg, Pain Quality, Pain Magnitude) and as many specific subdomains as needed to capture all of the ideas expressed (eg, under Pain Quality, subdomains such as sharp, achy, and throbbing). Fifteen pain quality subdomains were identified as most common. Nine of these demonstrated significant between-group differences in frequency. For example, patients with FM described their pain as achy more often than patients with LBP or HA; patients with HA described their pain as more throbbing than patients with LBP or FM; and patients with LBP described their pain as more shooting than patients with FM or HA. With the 15 pain quality subdomains representing the universe of most important pain qualities to assess, only 2 of 8 descriptive measures of pain quality were determined to have content validity. The findings are generally consistent with a study that used similar procedures in other patient samples to identify the most common words patients use to describe pain, supporting their generalizability. The findings also support the use of pain quality measures for discriminating between chronic pain conditions. Finally, the findings have important implications for evaluating and modifying pain quality measures as needed.
102 例腰痛(LBP)、100 例纤维肌痛(FM)和 100 例头痛(HA)患者被要求用自己的语言描述疼痛,然后将他们使用的词语和短语分类为 7 个全球域(例如,疼痛质量、疼痛程度)和尽可能多的特定子域,以捕捉所有表达的想法(例如,在疼痛质量下,子域如尖锐、酸痛和悸动)。确定了 15 个最常见的疼痛质量子域。其中 9 个在组间频率上存在显著差异。例如,FM 患者比 LBP 或 HA 患者更频繁地描述他们的疼痛为酸痛;HA 患者比 LBP 或 FM 患者更频繁地描述他们的疼痛为悸动;而 LBP 患者比 FM 或 HA 患者更频繁地描述他们的疼痛为刺痛。用这 15 个疼痛质量子域代表评估最重要的疼痛质量的总体范围,仅 8 种疼痛质量描述性测量中的 2 种被确定具有内容有效性。这些发现与一项在其他患者样本中使用类似程序识别患者用来描述疼痛的最常见词语的研究基本一致,支持其普遍性。这些发现还支持使用疼痛质量措施来区分慢性疼痛状况。最后,这些发现对评估和修改疼痛质量措施具有重要意义。