Thakral Manu, Shi Ling, Foust Janice B, Patel Kushang V, Shmerling Robert H, Bean Jonathan F, Leveille Suzanne G
Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA; Department of Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA, USA.
College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
Geriatr Nurs. 2018 Jul-Aug;39(4):450-456. doi: 10.1016/j.gerinurse.2018.01.001. Epub 2018 Feb 21.
Longitudinal assessment of chronic geriatric pain is complicated by an age-associated plateau in pain severity and increase in widespread pain, calling for innovative measures such as pain quality descriptors that characterize how pain may feel. We characterized persistence of pain quality and its relation to severity, activity interference and distribution of sites, in a population-based sample of adults aged≥70 years with chronic pain (n = 398). Persistent pain quality was defined as reporting descriptors within the same category: sensory, cognitive/affective, or neuropathic at baseline and 18 months. A count variable indicated number of persistent categories. Pain quality was highly persistent. Adjusted for baseline covariates, individuals endorsing 3 persistent categories were 2-2.5x more likely to experience more widespread pain at 18 months compared to fewer persistent categories. No associations were noted in changes in pain severity or interference. A comprehensive pain assessment that includes diverse pain quality descriptors may improve individualized pain management.
慢性老年疼痛的纵向评估因疼痛严重程度与年龄相关的平稳期以及广泛疼痛的增加而变得复杂，这就需要创新措施，如疼痛质量描述符，来描述疼痛的感受。我们在一个基于人群的70岁及以上慢性疼痛成年人样本（n = 398）中，对疼痛质量的持续性及其与严重程度、活动干扰和疼痛部位分布的关系进行了特征描述。持续性疼痛质量被定义为在基线和18个月时报告同一类别的描述符：感觉、认知/情感或神经性。一个计数变量表示持续性类别的数量。疼痛质量具有高度持续性。在对基线协变量进行调整后，与持续性类别较少的个体相比，认可3个持续性类别的个体在18个月时经历更广泛疼痛的可能性要高出2至2.5倍。在疼痛严重程度或干扰的变化方面未发现关联。包括多种疼痛质量描述符的全面疼痛评估可能会改善个体化疼痛管理。
