Block Phoebe R, Thorn Beverly E, Kapoor Shweta, White Jessica
Department of Psychology, University of Alabama, Tuscaloosa, AL.
Department of Psychology, University of Alabama, Tuscaloosa, AL.
Pain Manag Nurs. 2017 Apr;18(2):102-109. doi: 10.1016/j.pmn.2016.12.001. Epub 2017 Mar 2.
This study examined the relationships of self-reported pain intensity with vital signs, pain catastrophizing, and state anxiety in patients presenting to the emergency department (ED) for acute pain, exacerbations of chronic pain, or acute pain with concurrent chronic (combined) pain, comparing the pattern of relationships among these three pain groups. One hundred fifty-eight patients presenting to the ED for pain were recruited. Vital signs and self-reported pain intensity were obtained at triage, then participants completed self-report measures of pain catastrophizing, state anxiety, and demographic information. No significant associations were found between vital signs and pain intensity at triage in any of the pain groups. Pain catastrophizing was significantly associated with self-reported pain intensity in the acute pain group (r = .34, p < .05) and combined pain group (r = .30, p < .05), and state anxiety was significantly associated with self-reported pain intensity in with the acute pain group (r = .27, p < .05). When pain catastrophizing and state anxiety were used in a stepwise multiple regression analysis to predict self-reported pain intensity in the acute pain group, only pain catastrophizing emerged as a unique predictor (β = .405, p < .01). Consistent with previous research, vital signs were not associated with self-reported pain intensity in patients presenting to the ED for pain, including those with chronic pain. Given the significant association of pain catastrophizing and pain intensity among patients presenting to the ED for acute pain, brief measurement of pain catastrophizing may inform pain treatment in the ED.
本研究调查了因急性疼痛、慢性疼痛加重或急性疼痛并发慢性(合并)疼痛而前往急诊科(ED)就诊的患者自我报告的疼痛强度与生命体征、疼痛灾难化和状态焦虑之间的关系,并比较了这三组疼痛患者之间的关系模式。招募了158名因疼痛前往急诊科就诊的患者。在分诊时获取生命体征和自我报告的疼痛强度,然后参与者完成疼痛灾难化、状态焦虑和人口统计学信息的自我报告测量。在任何疼痛组中,分诊时生命体征与疼痛强度之间均未发现显著关联。在急性疼痛组(r = 0.34,p < 0.05)和合并疼痛组(r = 0.30,p < 0.05)中,疼痛灾难化与自我报告的疼痛强度显著相关;在急性疼痛组中,状态焦虑与自我报告的疼痛强度显著相关(r = 0.27,p < 0.05)。当使用疼痛灾难化和状态焦虑进行逐步多元回归分析以预测急性疼痛组中自我报告的疼痛强度时,只有疼痛灾难化成为唯一的预测因素(β = 0.405,p < 0.01)。与先前的研究一致,对于因疼痛前往急诊科就诊的患者,包括慢性疼痛患者,生命体征与自我报告的疼痛强度无关。鉴于因急性疼痛前往急诊科就诊的患者中疼痛灾难化与疼痛强度之间存在显著关联,对疼痛灾难化进行简短测量可能有助于急诊科的疼痛治疗。