a Department of Orthopaedic Surgery , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
b Department of Orthopaedic Surgery , Medical Center Leeuwarden , Leeuwarden , The Netherlands.
Disabil Rehabil. 2019 Apr;41(8):941-947. doi: 10.1080/09638288.2017.1413429. Epub 2017 Dec 8.
The modified painDETECT questionnaire (PDQ) is a self-reported questionnaire to discriminate between nociceptive and neuropathic-like pain in patients with knee/hip osteoarthritis (OA). This study aims to assess the structural and construct validity of this questionnaire.
Confirmatory factor analysis and hypothesis-testing was used. For 168 patients, predefined hypotheses were formulated on the correlation between the modified painDETECT and several other questionnaires, and in a subsample of 46 with pain pressure thresholds (PPTs).
Two principal components were confirmed. The pain pattern item did not load on any component. Eighty per cent of the hypotheses on the correlation between modified PDQ and the questionnaires were met, as were 50% concerning PPTs measurements.
This study is the first to assess structural and construct validity of the modified PDQ knee/hip by using factor analysis and hypothesis-testing. This questionnaire seems to reflect neuropathic-like pain symptoms experienced by hip/knee OA-patients with adequate validity. The item on pain pattern might not reflect the construct. More than 75% of the predefined hypotheses regarding the modified PDQ and the other questionnaires were met. Only 50% of the hypotheses on PPTs measurements were met, probably due to heterogeneity and limited size of this subsample. Implications for rehabilitation Pain in osteoarthritis (OA) is partly caused by modification of pain transmission in the peripheral and central nervous system, leading to sensitisation. This process seems particularly significant in a subgroup of OA patients. Sensitisation in OA is associated with more disability in daily life, lower quality of life and more widespread pain, as well as poorer outcome of total joint surgery. Screening for sensitisation can help to identify the subgroup of patients who could benefit from multidisciplinary treatment options focussing on desensitisation, cognitive- and behavioural therapy and reducing chronification of widespread pain. Therefore, being particularly important in the field of rehabilitation. The Dutch modified PainDETECT-questionnaire is very useful for rehabilitation professionals as it is one of the first questionnaires specifically validated to assess neuropathic-like symptoms (indicating sensitisation) in patients with knee or hip osteoarthritis.
改良疼痛 DETECT 问卷（PDQ）是一种自我报告问卷，用于区分膝/髋骨关节炎（OA）患者的伤害感受性和神经病理性疼痛。本研究旨在评估该问卷的结构和建构效度。
采用验证性因子分析和假设检验。对 168 例患者，根据改良 painDETECT 与其他几种问卷的相关性，以及 46 例有疼痛压力阈值（PPT）的亚组患者，制定了预设假设。
确认了两个主要成分。疼痛模式项目未加载到任何组件上。改良 PDQ 与问卷之间 80%的假设相关性得到满足，50%与 PPTs 测量相关的假设得到满足。
本研究首次通过因子分析和假设检验评估改良 PDQ 膝关节/髋关节的结构和建构效度。该问卷似乎反映了髋/膝关节 OA 患者的神经病理性疼痛症状，具有足够的有效性。疼痛模式项目可能无法反映结构。超过 75%的关于改良 PDQ 和其他问卷的预设假设得到满足。只有 50%关于 PPTs 测量的假设得到满足，这可能是由于该亚组的异质性和有限的样本量所致。
骨关节炎（OA）的疼痛部分是由于外周和中枢神经系统的疼痛传递发生改变引起的，导致敏化。这个过程在 OA 患者的一个亚组中尤为显著。OA 中的敏化与日常生活中更多的残疾、更低的生活质量和更广泛的疼痛以及全关节置换手术结果更差有关。对敏化的筛查可以帮助识别出那些可能受益于以脱敏、认知和行为治疗以及减少广泛疼痛的慢性化为重点的多学科治疗方案的患者亚组。因此，在康复领域尤为重要。荷兰改良的疼痛 DETECT 问卷对康复专业人员非常有用，因为它是专门用于评估膝或髋骨关节炎患者神经病理性症状（表示敏化）的首批问卷之一。
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