School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
Disabil Health J. 2013 Oct;6(4):369-76. doi: 10.1016/j.dhjo.2013.04.007. Epub 2013 May 28.
Most studies that investigate the impact of pain on function have focused on a particular pain site and use unidimensional measures of disability, making it difficult to know how pain impacts on different areas of functioning and whether different pain characteristics impact differently on function.
To investigate the relationship between pain characteristics and self-reported disability in patients with musculoskeletal pain aged ≥50 years.
Two hundred and four consecutive patients with musculoskeletal pain aged ≥50 years had their pain assessed (frequency, global pain intensity, pain intensity for the most painful site, location and number of pain sites) and were asked to fill in the World Health Organization Disability Assessment Schedule (WHODAS 2.0) that assesses disability in 6 domains of daily life.
Most patients reported chronic (77.5%), multisite or widespread (55.4%) pain that was always present (90.2%) and of moderate to severe intensity (mean score for global pain intensity = 5.91; SD = 2.02). Mean WHODAS 2.0 total score was 28.06 and SD was 19.86, corresponding to moderate disability. When entering age, sex, level of education, depression, number of comorbid chronic conditions and pain characteristics in a stepwise regression analysis, global pain intensity was the most important predictor for the domains of getting around (adjusted R(2) = 0.21, p < 0.001), self-care (adjusted R(2) = 0.14, p < 0.001), household activities (adjusted R(2) = 0.20, p < 0.001) and work (adjusted R(2) = 0.34, p < 0.001) and total score (adjusted R(2) = 0.19, p < 0.001).
Pain intensity seems to be an important predictor of disability for several domains of life, suggesting that pain-related disability should be assessed for these domains.
大多数研究疼痛对功能的影响都集中在特定的疼痛部位,并使用单一维度的残疾测量方法,这使得我们难以了解疼痛如何影响不同的功能领域,以及不同的疼痛特征对功能的影响是否不同。
调查≥50 岁的肌肉骨骼疼痛患者的疼痛特征与自我报告残疾之间的关系。
对 204 例≥50 岁的肌肉骨骼疼痛患者进行疼痛评估(频率、整体疼痛强度、最痛部位的疼痛强度、疼痛部位的位置和数量),并要求他们填写世界卫生组织残疾评估表(WHODAS 2.0),该表评估日常生活中的 6 个领域的残疾情况。
大多数患者报告慢性(77.5%)、多部位或广泛(55.4%)疼痛,疼痛始终存在(90.2%),且疼痛强度为中度至重度(整体疼痛强度平均得分为 5.91;标准差为 2.02)。WHODAS 2.0 总得分的平均值为 28.06,标准差为 19.86,对应于中度残疾。在逐步回归分析中,当输入年龄、性别、教育水平、抑郁、合并慢性疾病的数量和疼痛特征时,整体疼痛强度是行动能力(调整后的 R²=0.21,p<0.001)、自我护理(调整后的 R²=0.14,p<0.001)、家务活动(调整后的 R²=0.20,p<0.001)和工作(调整后的 R²=0.34,p<0.001)以及总分(调整后的 R²=0.19,p<0.001)的最重要预测因素。
疼痛强度似乎是生活中几个领域残疾的重要预测因素,这表明应该评估这些领域的疼痛相关残疾。