Donath Carolin, Geiß Christa, Schön Christoph
Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
Interdisciplinary Pain Center, University Clinic Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Germany.
BMC Health Serv Res. 2018 Feb 17;18(1):117. doi: 10.1186/s12913-018-2911-6.
The study aims to validate a previously developed and published combined success criterion for patients after multimodal pain therapy (Donath et al., BMC Health Serv Res 15:272, 2015). The criterion classifies treated patients as successful in the long term on the basis of pain severity, disability through pain, depressiveness, and health-related quality of life.
Routine longitudinal data of 135 pain patients treated with multimodal pain therapy in 2014-2015 at the Interdisciplinary Pain Center of the University Clinic Erlangen were available at baseline, therapy start, therapy end, and 12 months after treatment. Patients were, on average, 51.0 (SD 11.1) years old and to 63.7% female, two thirds were employed (66.7%). We conducted an analysis of concurrent validity (with: pain severity, disability through pain, depressiveness, mental and physical quality of life), criterion validity (with disability days, self-rated success), convergent validity (with stress, anxiety, well-being), and discriminant validity (with chronicity of pain, comorbidity), objectivity, and reliability. Statistically, descriptive and inference statistics, graphical methods and MANOVAs were used.
Patients classified as successful had significantly better values on the 5 variables demonstrating concurrent validity (all p < .001), significantly fewer Disability days (M = 15.31 (SD = 23.15) vs. M = 26.75 (SD = 29.15)); t (133) = 2.308; p = .024, less Anxiety (Pillai-Spur: F (3, 131) = 2.972, p = .034), less Stress (Pillai-Spur: F (3, 131) = 9.907, p < .001), and better Well-being (Pillai-Spur: F (3, 131) = 9.594, p < .001) 12 months after treatment than patients classified as not successful. The Spearman correlation between success classification and Chronicity stage was .094 (p = .280).
We demonstrated the validity of the combined success criterion with long-term data in addition to confirming the reliability and objectivity of the criterion. Future research might consider identifying predictors of success in multi-modal pain therapy.
本研究旨在验证先前制定并发表的多模式疼痛治疗后患者综合成功标准（多纳特等人，《BMC卫生服务研究》15:272，2015年）。该标准根据疼痛严重程度、因疼痛导致的残疾、抑郁程度以及与健康相关的生活质量，将接受治疗的患者长期分类为成功。
2014 - 2015年在埃尔朗根大学诊所跨学科疼痛中心接受多模式疼痛治疗的135名疼痛患者的常规纵向数据在基线、治疗开始、治疗结束以及治疗后12个月时可用。患者平均年龄为51.0（标准差11.1）岁，63.7%为女性，三分之二受雇（66.7%）。我们进行了同时效度分析（与：疼痛严重程度、因疼痛导致的残疾、抑郁程度、心理和生理生活质量）、标准效度分析（与残疾天数、自我评定的成功度）、收敛效度分析（与压力、焦虑、幸福感）以及区分效度分析（与疼痛慢性程度、合并症）、客观性和可靠性分析。在统计学上，使用了描述性和推断性统计、图形方法以及多变量方差分析。
被分类为成功的患者在证明同时效度的5个变量上具有显著更好的值（所有p <.001），残疾天数显著更少（M = 15.31（标准差 = 23.15）对M = 26.75（标准差 = 29.15））；t(133) = 2.308；p =.024，焦虑程度更低（皮莱 - 斯布尔检验：F(3, 131) = 2.972，p =.034），压力更低（皮莱 - 斯布尔检验：F(3, 131) = 9.907，p <.001），并且在治疗后12个月时的幸福感更好（皮莱 - 斯布尔检验：F(3, 131) = 9.594，p <.001），比被分类为不成功的患者。成功分类与慢性程度阶段之间的斯皮尔曼相关性为.094（p =.280）。
除了确认该标准的可靠性和客观性之外，我们还用长期数据证明了综合成功标准的效度。未来的研究可能会考虑确定多模式疼痛治疗成功的预测因素。
