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一种评估血友病患者疼痛的新方法:多维血友病疼痛问卷(MHPQ)。

A new measure to assess pain in people with haemophilia: The Multidimensional Haemophilia Pain Questionnaire (MHPQ).

机构信息

Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.

ICVS / 3B's-PT Government Associate Laboratory, Braga / Guimarães, Portugal.

出版信息

PLoS One. 2018 Nov 28;13(11):e0207939. doi: 10.1371/journal.pone.0207939. eCollection 2018.

Abstract

People with haemophilia (PWH) experience acute pain during joint bleeds and might develop chronic pain due to joint degeneration. However, there is a lack of standardized measures to comprehensively assess pain in PWH. This study aimed to develop a multidimensional questionnaire for haemophilia-related pain, the Multidimensional Haemophilia Pain Questionnaire (MHPQ), and to present initial validation data among adults.The questionnaire distinguishes between acute/chronic pain and queries about pain locations, duration, frequency, triggering factors, intensity, interference, strategies, specialists for pain management and satisfaction with treatment. An initial version was tested with 16 patients to ensure item comprehensibility and face validity. The final version was answered by 104 adults, with 82 (78.8%) reporting haemophilia-related pain in the previous year (mean age = 43.17; SD = 13.00). The non-response analysis revealed good item acceptability. Exploratory and confirmatory factor analysis (EFA/CFA), reliability (internal consistency, test-retest, inter-item and item-total correlations) and convergent validity were analysed for the intensity and interference dimensions of the questionnaire. A combined EFA with these two constructs supported a 2-factor structure distinguishing intensity (α = 0.88) from interference items (α = 0.91). CFA was tested for the interference dimension, demonstrating suitability for this sample. Item-total correlations were >0.30 on both dimensions and most inter-item correlations were <0.70. Test-retest reliability (n = 42) was good for intensity (r = 0.88) and interference (r = 0.73), and convergent validity was confirmed for most hypotheses (r>0.30).This questionnaire is a comprehensible tool, achieving a thorough assessment of relevant pain dimensions. The MHPQ can help guide treatment recommendations by highlighting relevant topics and contributing to more effective, integrated treatments.

摘要

患有血友病(PWH)的人在关节出血时会经历急性疼痛,并且由于关节退化可能会发展为慢性疼痛。然而,目前缺乏全面评估 PWH 疼痛的标准化措施。本研究旨在开发一种用于血友病相关疼痛的多维问卷,即多维血友病疼痛问卷(MHPQ),并介绍成人患者的初步验证数据。该问卷区分急性/慢性疼痛,并查询疼痛部位、持续时间、频率、触发因素、强度、干扰、策略、疼痛管理专家以及对治疗的满意度。初始版本在 16 名患者中进行了测试,以确保项目的理解性和表面有效性。最终版本由 104 名成年人回答,其中 82 名(78.8%)在过去一年中报告有血友病相关疼痛(平均年龄=43.17;SD=13.00)。非响应分析表明项目具有良好的可接受性。对问卷的强度和干扰维度进行了探索性和验证性因素分析(EFA/CFA)、可靠性(内部一致性、测试-重测、项目间和项目总分相关性)以及聚合效度分析。对这两个结构的联合 EFA 支持了区分强度(α=0.88)和干扰项(α=0.91)的 2 因素结构。对干扰维度进行了 CFA 测试,证明该样本适合。两个维度的项目总分相关性均>0.30,大多数项目间相关性均<0.70。测试-重测信度(n=42)对强度(r=0.88)和干扰(r=0.73)均良好,且大多数假设的聚合效度均得到验证(r>0.30)。该问卷是一种易于理解的工具,可以全面评估相关疼痛维度。MHPQ 可以帮助指导治疗建议,突出相关主题,并促进更有效、综合的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5b0/6261605/9cb6c763b929/pone.0207939.g001.jpg

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