Keefe Francis J, Caldwell David S, Queen Kate, Gil Karen M, Martinez Salutario, Crisson James E, Ogden William, Nunley James
Pain Management Program, Duke University Medical Center,Durham, NC 27710 U.S.A.
Pain. 1987 Mar;28(3):309-321. doi: 10.1016/0304-3959(87)90066-2.
This study used behavioral assessment techniques to analyze pain in osteoarthritis (OA) patients. Eighty-seven OA patients having chronic knee pain served as subjects. Pain behavior was evaluated using a standard observation method and functional impairment was assessed using the Arthritis Impact Measurement Scales. Data analysis revealed that pain and limitations in physical activities were the most common functional impairments and that the most frequently observed pain behavior was guarded movement. Predictive analyses indicated that disability support status and scores on a Pain Control and Rational Thinking factor of the Coping Strategies Questionnaire (CSQ) were predictive of functional impairment. Patients receiving disability support payments were much more functionally limited than those not receiving this financial support. Patients scoring high on the Pain Control and Rational Thinking factor of the CSQ were much less functionally impaired, walked a 5 m course more rapidly and moved from a standing to a sitting or reclining position more quickly than patients scoring low on this factor. The implications of these results for behavioral treatment of OA knee pain are discussed.
本研究采用行为评估技术分析骨关节炎（OA）患者的疼痛情况。87名患有慢性膝关节疼痛的OA患者作为研究对象。使用标准观察方法评估疼痛行为，并使用关节炎影响测量量表评估功能障碍。数据分析表明，疼痛和身体活动受限是最常见的功能障碍，最常观察到的疼痛行为是保护性动作。预测分析表明，残疾支持状况以及应对策略问卷（CSQ）中疼痛控制与理性思维因子的得分可预测功能障碍。领取残疾补助金的患者在功能上比未领取此项经济支持的患者受到更多限制。在CSQ的疼痛控制与理性思维因子上得分高的患者，其功能障碍程度要比得分低的患者轻得多，在5米路程中行走速度更快，从站立姿势转变为坐姿或躺姿也更快。本文讨论了这些结果对OA膝关节疼痛行为治疗的意义。
