J Oral Facial Pain Headache. 2016 Winter;30(1):14-20. doi: 10.11607/ofph.1482.
To explore whether temporomandibular disorder (TMD) pain patients reporting different levels of pain-related disability differ in terms of illness explanations and treatment expectations.
Consecutive TMD pain patients (n = 399; mean ± SD age, 40.5 ± 12.7 years; 83% women) seeking treatment in primary care completed the Explanatory Model Scale (EMS). Patients were asked to indicate their expectations regarding the treatment. Each patient's pain-related disability level was determined using the Graded Chronic Pain Scale, with scores indicating no (0 disability points), low (1-2 disability points), or high (3-6 disability points) disability. Differences between EMS factor scores were evaluated using the Mann-Whitney U test. Differences between study groups were analyzed using logistic regression.
High-disability patients considered physical and stress factors as more important in causing and in aggravating pain and as targets of treatment compared with patients with no disability (P = .0196 and P = .0251, respectively). The great majority of patients indicated they would like to receive information, decrease pain, and increase jaw function, with no significant subtype differences noted. Compared with no-disability patients, low-disability and high-disability patients were more likely to expect increased ability to perform daily functions (P < .0001 in both comparisons), increased work ability (P < .0001 in both comparisons), and better stress management skills (P = .0014 and P = .0001, respectively).
Illness explanations and goals for treatment differ in patients reporting different levels of TMD pain-related disability.
探讨报告不同程度疼痛相关残疾的颞下颌关节紊乱（TMD）疼痛患者在疾病解释和治疗期望方面是否存在差异。
连续就诊于初级保健的 TMD 疼痛患者（n=399；平均年龄±标准差，40.5±12.7 岁；83%为女性）完成了疾病解释量表（EMS）。要求患者表明对治疗的期望。每位患者的疼痛相关残疾程度采用慢性疼痛分级量表确定，分数表示无残疾（0 残疾点）、低残疾（1-2 残疾点）或高残疾（3-6 残疾点）。使用 Mann-Whitney U 检验评估 EMS 因子得分之间的差异。使用逻辑回归分析研究组之间的差异。
高残疾患者认为物理和应激因素在引起和加重疼痛方面比无残疾患者更重要，并且是治疗的目标（P=0.0196 和 P=0.0251）。绝大多数患者表示希望获得信息、减轻疼痛和增加下颌功能，没有明显的亚型差异。与无残疾患者相比，低残疾和高残疾患者更有可能期望提高日常功能的能力（两种比较均 P<0.0001）、提高工作能力（两种比较均 P<0.0001）和更好的压力管理技能（P=0.0014 和 P=0.0001）。
报告不同程度 TMD 疼痛相关残疾的患者在疾病解释和治疗目标方面存在差异。
