Multidisciplinary Pain Centre, Division of Clinical Pharmacology and Toxicology & Division of General Medical Rehabilitation, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
PLoS One. 2013 Nov 11;8(11):e79988. doi: 10.1371/journal.pone.0079988. eCollection 2013.
Pain is the primary outcome measurement in osteoarthritis, and its assessment is mostly based on its intensity. The management of this difficult chronic condition could be improved by using pain descriptors to improve analyses of painful sensations. This should help to define subgroups of patients based on pain phenotype, for more adapted treatment. This study draws upon patients' descriptions of their pain, to identify and understand their perception of osteoarthritis pain and to categorize pain dimensions.
This qualitative study was conducted with representative types of patients suffering from osteoarthritis. Two focus groups were conducted with a sample of 14 participants, with either recent or chronic OA, at one or multiple sites. Focus groups were semi-structured and used open-ended questions addressing personal experiences to explore the experiences of patients with OA pain and the meanings they attributed to these pains.
TWO MAIN POINTS EMERGED FROM CONTENT ANALYSES: -A major difficulty in getting patients to describe their osteoarthritis pain: perception that nobody wants to hear about it; necessity to preserve one's self and social image; notion of self-imposed stoicism; and perception of osteoarthritis as a complex, changing, illogical disease associated with aging. -Osteoarthritis pains were numerous and differed in intensity, duration, depth, type of occurrence, impact and rhythm, but also in painful sensations and associated symptoms. Based on analyses of the verbatim interviews, seven dimensions of OA pain emerged: pain sensory description, OA-related symptoms, pain variability profile, pain-triggering factors, pain and physical activity, mood and image, general physical symptoms.
In osteoarthritis, pain analysis should not be restricted to intensity. Our qualitative study identified pain descriptors and defined seven dimensions of osteoarthritis pain. Based on these dimensions, we aim to develop a specific questionnaire on osteoarthritis pain quality for osteoarthritis pain phenotyping: the OsteoArthritis Symptom Inventory Scale (OASIS).
疼痛是骨关节炎的主要结局测量指标，其评估主要基于其强度。通过使用疼痛描述符来改善对疼痛感觉的分析，可以改善这种难以治疗的慢性疾病的管理。这有助于根据疼痛表型定义患者亚组，以进行更适应的治疗。本研究基于患者对其疼痛的描述，以识别和理解他们对骨关节炎疼痛的感知，并对疼痛维度进行分类。
这项定性研究是在患有骨关节炎的代表性类型的患者中进行的。对 14 名参与者进行了两个焦点小组，这些参与者患有近期或慢性 OA，病变部位为一个或多个。焦点小组采用半结构化方法，使用开放式问题来探讨患者 OA 疼痛的经历以及他们对这些疼痛的理解，以探索患者的经历。
内容分析得出两个主要观点：- 让患者描述其骨关节炎疼痛存在很大困难：认为没有人想听他们的痛苦；需要维护自己和社会形象；自我强加的坚忍观念；以及将骨关节炎视为一种与衰老相关的复杂、多变、不合逻辑的疾病。- 骨关节炎疼痛多种多样，其强度、持续时间、深度、发作类型、影响和节律不同，但也有疼痛感觉和相关症状。基于对逐字访谈的分析，出现了骨关节炎疼痛的七个维度：疼痛感觉描述、与 OA 相关的症状、疼痛可变性特征、疼痛触发因素、疼痛与身体活动、情绪和形象、一般身体症状。
在骨关节炎中，疼痛分析不应仅限于强度。我们的定性研究确定了疼痛描述符，并定义了骨关节炎疼痛的七个维度。基于这些维度，我们旨在开发一种专门用于骨关节炎疼痛表型的骨关节炎疼痛质量问卷：骨关节炎症状量表 (OASIS)。
