用于测量住院疼痛患者焦虑的视觉模拟评分的实用性：一项多中心横断面研究。

Usefulness of a Visual Analog Scale for Measuring Anxiety in Hospitalized Patients Experiencing Pain: A Multicenter Cross-Sectional Study.

机构信息

Department of Rheumatology, Saint-Philibert Catholic Hospital, University of Lille, Lomme, France.

Pain Center, Saint-Vincent Catholic Hospital, University of Lille, Lille, France.

出版信息

Pain Manag Nurs. 2020 Dec;21(6):572-578. doi: 10.1016/j.pmn.2020.03.004. Epub 2020 May 1.

DOI:10.1016/j.pmn.2020.03.004

PMID:32362472

Abstract

BACKGROUND

Anxiety is common in hospitalized patients and can worsen pain or lead to unsuccessful pain relief.

AIMS

The purpose of this study was to evaluate the usefulness of measuring anxiety with a visual analog scale (VAS) in the hospitalized patient experiencing pain.

DESIGN

We conducted a multiple-center cross-sectional study.

PARTICIPANTS/SUBJECTS: Adult inpatients experiencing moderate to severe pain defined by a pain VAS score ≥40 of 100 were included.

METHODS

Pain and anxiety data were collected using the following instruments: pain VAS, anxiety VAS, State Anxiety Scale of the Spielberger State-Trait Anxiety Inventory (STAI-YA) and Anxiety Subscale of the Hospital Anxiety and Depression Scale (HAD-A).

RESULTS

Data were collected from 394 patients. Of those patients, 43.6% (171 of 392) and 36.6% (143 of 391) had significant anxiety according to STAI-Ya and HAD-A, respectively. Correlation was good between anxiety-VAS and STAI-YA (ρ = 0.67 [95% confidence interval 0.61-0.72]) and moderate between anxiety VAS and HAD-D (ρ = 0.48 [0.39-0.56]). The main factor predictive of situational anxiety was history of anxiety-depression symptoms (odds ratio = 2.95 [1.93-4.56]). For anxiety VAS score ≥ 40 of 100, the sensitivity for detecting anxiety was 81% with 70% specificity.

CONCLUSION

This study confirmed the high prevalence of anxiety among inpatients experiencing pain, demonstrated the capacity of a VAS to assess this anxiety, determined an anxiety VAS cutoff level to screen for significant anxiety, and identified risk factors of anxiety in this population. Anxiety VAS has been found to be an easy-to-use method familiar to caregivers, with all the advantages needed for an effective screening instrument. An anxiety VAS score ≥40 of 100 would thus warrant particular attention to adapt care to the patient's anxiety-related pain and initiate specific therapeutic interventions.

摘要

背景

焦虑在住院患者中很常见，它可能会加重疼痛或导致疼痛缓解失败。

目的

本研究旨在评估使用视觉模拟量表（VAS）测量住院患者疼痛时的焦虑程度的有效性。

设计

我们进行了一项多中心横断面研究。

参与者/受试者：纳入的成年住院患者经历中度至重度疼痛，疼痛 VAS 评分≥40/100。

方法

使用以下工具收集疼痛和焦虑数据：疼痛 VAS、焦虑 VAS、状态焦虑量表 Spielberger 状态特质焦虑量表（STAI-YA）和医院焦虑和抑郁量表（HAD-A）焦虑分量表。

结果

从 394 名患者中收集数据。根据 STAI-Ya 和 HAD-A，分别有 43.6%（171/392）和 36.6%（143/391）的患者存在显著焦虑。焦虑-VAS 与 STAI-Ya 之间的相关性良好（ρ=0.67[95%置信区间 0.61-0.72]），与 HAD-D 之间的相关性中等（ρ=0.48[0.39-0.56]）。预测情境性焦虑的主要因素是焦虑抑郁症状史（优势比=2.95[1.93-4.56]）。对于焦虑 VAS 评分≥100 的 40，其检测焦虑的灵敏度为 81%，特异性为 70%。

结论

本研究证实了住院疼痛患者中焦虑的高患病率，证明了 VAS 评估这种焦虑的能力，确定了用于筛选显著焦虑的焦虑 VAS 截断值，并确定了该人群中焦虑的危险因素。焦虑 VAS 已被发现是一种易于使用的方法，护理人员熟悉，具有有效筛选工具所需的所有优势。因此，焦虑 VAS 评分≥100/100 应特别注意调整患者的焦虑相关疼痛护理，并启动特定的治疗干预措施。