Charoenpol Fa-Ngam, Tontisirin Nuj, Leerapan Borwornsom, Seangrung Rattaphol, Finlayson Roderick J
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand,
J Pain Res. 2019 Jan 23;12:477-487. doi: 10.2147/JPR.S186105. eCollection 2019.
Pain diaries are a valuable self-assessment tool; however, their use in chronic non-cancer pain has received limited attention. In this study, we examined the effect of pain diary use on pain intensity, interference, and intrapersonal change in patients with chronic non-cancer pain.
A convergent mixed-methods design was used to prospectively evaluate a cohort of 72 patients. Daily pain intensity and weekly pain-interference were self-reported using pain diaries for a 4-week period. Outcomes were assessed by examining changes in pain scores (primary outcome) as well as the Brief Pain Inventory and Short-form McGill Pain Questionnaire-2. In addition, qualitative data obtained from pain diary entries and focus-group interviews were analyzed using thematic content analysis.
Pain intensity and average pain scores were significantly lower after using the diaries. Participants reported less pain interference in mood, walking ability, normal work, and enjoyment of life. No differences were found in SF-MPQ-2 scores. Qualitative analysis indicated that better pain recognition and more effective communication with care providers led to improved self-management and more effectual treatment plans.
Use of a pain diary in patients with chronic non-cancer pain was associated with reduced pain intensity and improved mood as well as function. Further controlled trials examining the long-term effects of pain diaries are warranted.
疼痛日记是一种有价值的自我评估工具;然而,其在慢性非癌性疼痛中的应用受到的关注有限。在本研究中,我们考察了使用疼痛日记对慢性非癌性疼痛患者的疼痛强度、干扰及个人变化的影响。
采用聚合混合方法设计对72名患者进行前瞻性评估。在为期4周的时间里,患者使用疼痛日记自我报告每日疼痛强度和每周疼痛干扰情况。通过检查疼痛评分的变化(主要结局)以及简明疼痛问卷和简化版麦吉尔疼痛问卷-2来评估结局。此外,使用主题内容分析法对从疼痛日记条目和焦点小组访谈中获得的定性数据进行分析。
使用日记后,疼痛强度和平均疼痛评分显著降低。参与者报告在情绪、行走能力、正常工作和生活乐趣方面的疼痛干扰减少。简化版麦吉尔疼痛问卷-2评分未发现差异。定性分析表明,更好地识别疼痛以及与医护人员更有效的沟通导致自我管理得到改善,治疗计划更有效。
慢性非癌性疼痛患者使用疼痛日记与疼痛强度降低、情绪及功能改善相关。有必要进行进一步的对照试验以考察疼痛日记的长期效果。