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从患者角度看疼痛强度意味着什么?:一项关于患者对疼痛强度作为治疗评估结果参数的看法以及疼痛强度测量可解释性的定性研究

[What does pain intensity mean from the patient perspective? : A qualitative study on the patient perspective of pain intensity as an outcome parameter in treatment evaluation and on the interpretability of pain intensity measurements].

作者信息

Neustadt K, Deckert S, Kopkow C, Preißler A, Bosse B, Funke C, Jacobi L, Mattenklodt P, Nagel B, Seidel P, Sittl R, Steffen E, Sabatowski R, Schmitt J, Kaiser U

机构信息

Universitäts-SchmerzCentrum, Universitätsklinikum Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.

Zentrum für Evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät, TU Dresden, Dresden, Deutschland.

出版信息

Schmerz. 2017 Dec;31(6):580-593. doi: 10.1007/s00482-017-0234-x.

DOI:10.1007/s00482-017-0234-x
PMID:28660417
Abstract

BACKGROUND

Pain intensity (PI) is a common outcome parameter in effectiveness studies on interdisciplinary multimodal pain therapy (IMPT), despite the fact that IMPT highlights dealing with rather than reducing chronic pain. Moreover, the measurement of pain intensity as a highly subjective experience is problematic. Patient participation is absolutely essential to examine the relevance of PI as a criterion of treatment success as well as to select/develop suitable measurement methods.

METHOD

A qualitative multicenter study was conducted using focus groups with 69 patients (18-77 years; 80% female) at four different IMPT centers in Germany to discuss pain intensity as a therapy outcome parameter in IMPT, as well as the interpretability and feasibility of common measurement methods.

RESULTS

The discussions emphasized that PI is a relevant, but not the primary, outcome in IMPT for patients. Patients' statements also demonstrate that there are some problems in measuring PI, for instance with regard to pain attacks.

CONCLUSIONS

The focus group discussions suggested that, due to the highly subjective nature of PI, as well as (verbal) inaccuracies and a lack of standardization in common instruments, the measurement of pain intensity is a challenging task. These limitations should be taken into account in future studies.

摘要

背景

疼痛强度(PI)是跨学科多模式疼痛治疗(IMPT)有效性研究中常用的结果参数,尽管IMPT强调应对慢性疼痛而非减轻疼痛。此外,将疼痛强度作为一种高度主观的体验进行测量存在问题。患者的参与对于检验PI作为治疗成功标准的相关性以及选择/开发合适的测量方法绝对至关重要。

方法

在德国四个不同的IMPT中心,对69名患者(18 - 77岁;80%为女性)进行了焦点小组定性多中心研究,以讨论疼痛强度作为IMPT治疗结果参数的情况,以及常用测量方法的可解释性和可行性。

结果

讨论强调,对于患者而言,PI是IMPT中一个相关但非主要的结果。患者的陈述还表明,在测量PI方面存在一些问题,例如在疼痛发作方面。

结论

焦点小组讨论表明,由于PI具有高度主观性,以及常用工具存在(语言)不准确和缺乏标准化的情况,疼痛强度的测量是一项具有挑战性的任务。在未来的研究中应考虑这些局限性。

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Pain. 2017 Oct;158(10):1853-1859. doi: 10.1097/j.pain.0000000000000902.
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Goals of Chronic Pain Management: Do Patients and Primary Care Physicians Agree and Does it Matter?慢性疼痛管理的目标:患者与初级保健医生意见一致吗?这重要吗?
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[结果研究中的患者观点:关于整理患者对多模式疼痛治疗效果判定观点的焦点小组概念的开发——一项试点研究]
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Pain. 2016 May;157(5):1056-1064. doi: 10.1097/j.pain.0000000000000502.
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