Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, New South Wales, Australia.
The St George Hospital Pain Management Unit, Kogarah, New South Wales, Australia.
Pain Pract. 2019 Apr;19(4):363-369. doi: 10.1111/papr.12748. Epub 2019 Jan 11.
Pain education is an important part of multidisciplinary management of chronic pain. The characteristics of people likely to have more improvement in pain biology knowledge following pain education are unknown.
To identify the baseline factors predicting changes in pain biology knowledge in adults with chronic pain following a 2-hour multidisciplinary pain education session.
Fifty-five adults with chronic pain attended a 2-hour pain education session prior to a multidisciplinary assessment at a pain clinic. Patients completed the 12-item revised Neurophysiology of Pain Questionnaire (rNPQ, score/12) before and after the pain education session. The primary outcome was change in pain biology knowledge, evaluated with the change in rNPQ score. Ten preselected predictors were investigated using univariate models followed by multivariable models with a manual forwards-building process.
Education level and age were significantly associated with change in rNPQ score in the univariate models. Participants with higher levels of education had, on average, 1.96 (0.68 to 3.23) points more improvement in rNPQ score than those with lower levels of education. For every 10 years older a participant was, his or her rNPQ score changed on average by 0.5 (0.1 to 0.8) points less. In the multivariable model, only the education level remained significant, explaining 17% of the variance (R = 0.17). The clinical variables that were assessed (pain severity, pain interference, pain self-efficacy, depression, anxiety, and pain catastrophizing) did not predict any knowledge change.
This study suggests that, of those patients with chronic pain who choose to attend pain education, more educated patients are more likely to improve their pain biology knowledge after a pain education session.
疼痛教育是慢性疼痛多学科管理的重要组成部分。接受疼痛教育后疼痛生物学知识改善幅度较大的人群特征尚不清楚。
确定参加 2 小时多学科疼痛教育课程的慢性疼痛成年患者在疼痛教育后疼痛生物学知识变化的基线预测因素。
55 例慢性疼痛患者在疼痛诊所进行多学科评估前参加了 2 小时的疼痛教育课程。患者在疼痛教育课程前后完成了 12 项修订神经生理学疼痛问卷（rNPQ，得分/12）。主要结局是疼痛生物学知识的变化，用 rNPQ 评分的变化来评估。使用单变量模型对 10 个预先选择的预测因素进行了调查，然后使用手动向前构建过程进行多变量模型。
在单变量模型中，教育水平和年龄与 rNPQ 评分的变化显著相关。受教育程度较高的患者平均比受教育程度较低的患者 rNPQ 评分提高了 1.96 分（0.68 至 3.23 分）。参与者每增加 10 岁，其 rNPQ 评分平均降低 0.5 分（0.1 至 0.8 分）。在多变量模型中，只有教育水平仍然显著，解释了 17%的方差（R²=0.17）。评估的临床变量（疼痛严重程度、疼痛干扰、疼痛自我效能、抑郁、焦虑和疼痛灾难化）不能预测任何知识变化。
本研究表明，在选择参加疼痛教育的慢性疼痛患者中，受教育程度较高的患者在接受疼痛教育课程后，更有可能提高其疼痛生物学知识。
