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慢性疼痛的心理社会和功能影响评估

Assessment of Psychosocial and Functional Impact of Chronic Pain.

作者信息

Turk Dennis C, Fillingim Roger B, Ohrbach Richard, Patel Kushang V

机构信息

Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington.

Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida.

出版信息

J Pain. 2016 Sep;17(9 Suppl):T21-49. doi: 10.1016/j.jpain.2016.02.006.

Abstract

UNLABELLED

The psychosocial and functional consequences of chronic pain disorders have been well documented as having significant effects on the experience of pain, presentation to health care providers, responsiveness to and participation in treatment, disability, and health-related quality of life. Thus, psychosocial and functional consequences have been incorporated as 1 of the 5 dimensions within the integrated Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION)-American Pain Society (APS) Pain Taxonomy (AAPT): 1) core diagnostic criteria; 2) common features; 3) common medical comorbidities; 4) neurobiological, psychosocial, and functional consequences; and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors. In this article we review the rationale for a biopsychosocial perspective, on the basis of current evidence, and describe a set of key psychosocial and behavioral factors (eg, mood/affect, coping resources, expectations, sleep quality, physical function, and pain-related interference with daily activities) that are important consequences of persistent pain and that should be considered when classifying patients within the comprehensive AAPT chronic pain structure. We include an overview of measures and procedures that have been developed to assess this set of factors and that can be used as part of the comprehensive assessment and classification of pain and to address specific research questions.

PERSPECTIVE

Psychosocial and functional consequences are important considerations in the classification of individuals with chronic pain. A set of key psychosocial and behavioral factors (eg, mood/affect, coping resources, expectations, sleep quality, physical function, and pain-related interference with daily activities) that should be considered when classifying patients within the comprehensive classification of chronic pain disorders developed by the AAPT are outlined and examples of assessment methods for each are described.

摘要

未标注

慢性疼痛障碍的心理社会和功能后果已有充分记录,这些后果对疼痛体验、向医疗服务提供者求诊、对治疗的反应和参与度、残疾状况以及与健康相关的生活质量都有重大影响。因此,心理社会和功能后果已被纳入综合镇痛、麻醉和成瘾临床试验转化、创新、机会与网络(ACTTION)-美国疼痛学会(APS)疼痛分类法(AAPT)的五个维度之一:1)核心诊断标准;2)共同特征;3)常见医学合并症;4)神经生物学、心理社会和功能后果;5)假定的神经生物学和心理社会机制、风险因素和保护因素。在本文中,我们根据现有证据回顾了生物心理社会视角的基本原理,并描述了一组关键的心理社会和行为因素(如情绪/情感、应对资源、期望、睡眠质量、身体功能以及疼痛对日常活动的干扰),这些因素是持续性疼痛的重要后果,在将患者纳入全面的AAPT慢性疼痛结构进行分类时应予以考虑。我们概述了为评估这组因素而开发的测量方法和程序,这些方法可作为疼痛综合评估和分类的一部分,并用于解决特定的研究问题。

观点

心理社会和功能后果是慢性疼痛患者分类中的重要考量因素。本文概述了在AAPT制定的慢性疼痛障碍综合分类中对患者进行分类时应考虑的一组关键心理社会和行为因素(如情绪/情感、应对资源、期望、睡眠质量、身体功能以及疼痛对日常活动的干扰),并描述了每种因素的评估方法示例。

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