Kleinke Chris L, Spangler Arthur Stephenson
Department of Psychology, University of Alaska, Anchorage, AK 99508 U.S.A. The Delphi Center, 44 Billings Rd., Quincy, MA 02171 U.S.A.
Pain. 1988 Apr;33(1):41-48. doi: 10.1016/0304-3959(88)90201-1.
Treatment outcome of 72 chronic back pain patients was assessed with 4 standardized measures: the McGill Pain Questionnaire, the Audiovisual Taxonomy of Pain Behavior, the Beck Depression Inventory, and the Profile of Mood States. Patients were also rated by their primary nurse on pain behavior, activity, drug-seeking, and sleep. Variables used to predict scores on outcome measures included patients' demographics and MMPI scores. Multiple regression analyses indicated that patients receiving worker's compensation engaged in more pain behavior and rated their pain as more severe, both upon admission and discharge from the pain program. High scores on the MMPI Hy scale were correlated with high self-ratings of pain and several MMPI scales correlated with negative mood. Even though demographic variables predicted admission and discharge scores on a number of treatment outcome measures, there was no relation between demographics and patients' improvement on treatment outcome measures. Patients with high scores on MMPI Hy and D scales displayed greatest admission to discharge improvement on self-rated pain and mood. Results were integrated with findings from previous studies. It was suggested that by distinguishing between overall scores on treatment outcome measures and improvement on these measures, professionals will be in a better position to devise individualized treatment plans for pain patients.
采用4种标准化方法对72例慢性背痛患者的治疗结果进行评估：麦吉尔疼痛问卷、疼痛行为视听分类法、贝克抑郁量表和情绪状态剖面图。患者的责任护士也对患者的疼痛行为、活动、药物寻求和睡眠情况进行评分。用于预测结果测量分数的变量包括患者的人口统计学特征和明尼苏达多相人格调查表（MMPI）分数。多元回归分析表明，领取工伤赔偿的患者在进入疼痛治疗项目时和出院时，表现出更多的疼痛行为，且对自身疼痛的评分更高。MMPI的癔症（Hy）量表高分与疼痛的高自我评分相关，并且几个MMPI量表与负面情绪相关。尽管人口统计学变量在一些治疗结果测量中能够预测进入治疗时和出院时的分数，但人口统计学特征与患者在治疗结果测量上的改善并无关联。MMPI的Hy量表和抑郁（D）量表得分高的患者在自我评定的疼痛和情绪方面，从进入治疗到出院的改善最为明显。研究结果与先前研究的发现相结合。研究表明，通过区分治疗结果测量的总体分数和这些测量上的改善情况，专业人员将能够更好地为疼痛患者制定个性化的治疗方案。
