Robinson-Papp Jessica, George Mary Catherine, Dorfman David, Simpson David M
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Pain Med. 2015 Jul;16(7):1256-64. doi: 10.1111/pme.12717. Epub 2015 Feb 17.
Preliminary evidence suggests that chronic pain patients complete pain intensity measures using idiosyncratic methods. Our objective was to understand these methods and how they might impact the psychometric properties of the instruments.
A qualitative focus-group based study.
An academic center in New York City.
Outpatients (n = 36) with chronic low back pain, or neuropathic pain due to diabetes or HIV.
Participants were divided into three focus groups based on their pain condition, and asked to discuss pain intensity measures (visual analog and numeric rating scales for average pain over 24 hours; Brief Pain Inventory; and McGill Pain Questionnaire). Audio-recordings were transcribed and analyzed using an inductive thematic method.
We discovered four main themes, and five sub-themes: 1) doubt that pain can be accurately measured (subthemes: pain measurement is influenced by things other than pain, the numbers used to rate pain do not have an absolute meaning, and preference for pain intensity ratings "in the middle" of the scale); 2) confusion regarding the definition of pain; 3) what experiences to use as referents (subthemes: appropriate comparator experiences and the interpretation of the anchors of the scale); and 4) difficulty averaging pain.
The themes discovered suggest that patients include sensations and experiences other than pain intensity in their ratings, experience the rating of pain as a comparative task, and do not use the scale in a linear manner. These themes are relevant to understanding the validity and scale properties of commonly used pain intensity measures.
初步证据表明，慢性疼痛患者采用独特的方法完成疼痛强度测量。我们的目的是了解这些方法以及它们可能如何影响测量工具的心理测量特性。
一项基于定性焦点小组的研究。
纽约市的一个学术中心。
患有慢性腰痛、糖尿病性神经病变性疼痛或HIV相关性神经病变性疼痛的门诊患者（n = 36）。
根据疼痛状况将参与者分为三个焦点小组，并要求他们讨论疼痛强度测量方法（24小时平均疼痛的视觉模拟量表和数字评定量表；简明疼痛问卷；以及麦吉尔疼痛问卷）。对录音进行转录，并采用归纳主题法进行分析。
我们发现了四个主要主题和五个子主题：1）对疼痛能否准确测量存在疑虑（子主题：疼痛测量受疼痛以外的因素影响、用于评定疼痛的数字没有绝对意义、偏好量表“中间”的疼痛强度评分）；2）对疼痛定义感到困惑；3）以何种经历作为参照（子主题：合适的比较经历以及量表锚定的解释）；4）疼痛平均化困难。
所发现的主题表明，患者在评分中纳入了疼痛强度以外的感觉和经历，将疼痛评分视为一项比较任务，并且不是以线性方式使用量表。这些主题与理解常用疼痛强度测量方法的效度和量表特性相关。
