Vartiainen Pekka, Heiskanen Tarja, Sintonen Harri, Roine Risto P, Kalso Eija
Division of Pain Medicine, Department of Anaesthesiology, Intensive Care, and Pain Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Department of Public Health, University of Helsinki, Helsinki, Finland.
Pain. 2016 Oct;157(10):2269-2276. doi: 10.1097/j.pain.0000000000000641.
Health-related quality of life (HRQoL) measurement aims to capture the complete, subjective health state of the patients and to comprehensively evaluate treatment outcomes. The aim of this study was to assess, using the 15D HRQoL instrument, HRQoL in a sample of 1528 chronic pain patients, referred to the multidisciplinary pain clinic of the Helsinki University Hospital during 2004 to 2012. The 15D results of the chronic pain patients were compared with those of a matched general population. To analyse the properties of the 15D, the results were compared with the preadmission questionnaire of the pain clinic, containing questions about background factors, aspects of the pain, and its impact on life. The mean 15D score of the chronic pain patients was one of the lowest reported using 15D; 0.710 vs 0.922 in the general population. It equalled the score of advanced cancer patients in palliative care. The 15D scores were normally distributed, and 15D showed both statistically and clinically significant discriminative power in pain-related background factors. Visual analogue scale on pain intensity, visual analogue scale on pain-related distress, and the impact of pain on daily life correlated well with the 15D score. Pain intensity did not have independent predictive value on the score. The results indicate heavy perceived burden of illness in chronic pain patients. In light of the questions analysed, 15D appears sensitive and discriminative in chronic pain patients in tertiary care. Instead of pain intensity, the impaired HRQoL in chronic pain was mainly because of the psychosocial aspects of pain.
健康相关生活质量（HRQoL）测量旨在获取患者完整的主观健康状况，并全面评估治疗效果。本研究的目的是使用15D HRQoL工具，评估2004年至2012年期间转诊至赫尔辛基大学医院多学科疼痛诊所的1528例慢性疼痛患者的HRQoL。将慢性疼痛患者的15D结果与匹配的普通人群的结果进行比较。为了分析15D的特性，将结果与疼痛诊所的入院前问卷进行比较，该问卷包含有关背景因素、疼痛方面及其对生活影响的问题。慢性疼痛患者的15D平均得分是使用15D报告的最低得分之一；普通人群为0.710，而普通人群为0.922。它与姑息治疗中晚期癌症患者的得分相当。15D得分呈正态分布，并且15D在与疼痛相关的背景因素中显示出统计学和临床意义上的显著鉴别力。疼痛强度视觉模拟量表、疼痛相关困扰视觉模拟量表以及疼痛对日常生活的影响与15D得分密切相关。疼痛强度对得分没有独立的预测价值。结果表明慢性疼痛患者存在严重的疾病感知负担。根据所分析的问题，15D在三级护理中的慢性疼痛患者中似乎具有敏感性和鉴别力。慢性疼痛中HRQoL受损的主要原因不是疼痛强度，而是疼痛的社会心理方面。
