From the Orthopaedic Surgery Department, Wayne State University, Detroit Medical Center, Detroit, MI (Dr. Vaidya); Orthopaedic Surgery Department, Detroit Medical Center Cardiovascular Institute, Detroit, MI (Mr. Washington and Dr. Stine); Orthopaedic Surgery Department, Detroit Medical Center, Detroit, MI (Dr. Geamanu); and US Army Institute of Surgical Research, Fort Sam Houston, TX (Dr. Hudson).
J Am Acad Orthop Surg Glob Res Rev. 2021 Sep 2;5(9):e21.00174. doi: 10.5435/JAAOSGlobal-D-21-00174.
INTRODUCTION: The objective of this study was to (1) construct a pain scale that improves communication between healthcare providers and patients (Interventional Pain Assessment [IPA] tool) and (2) to validate this new pain scale with the numeric rating scale of 0 to 10 Numerical Rating System (NRS). METHODS: The IPA uses only three categories: 0 = "I have no pain," 1 = "My pain is tolerable (no intervention needed)," and 2 = "my pain is intolerable, (intervention needed)." An Institutional Review Board-approved study was done on 322 consecutive patients who were recovering from fracture treatment. We compared ratings of the IPA with NRS. We also asked patients which scale they preferred. Statistical analysis included Kendall rank correlation (Kendall τ) and Spearman rho to determine correlation with the NRS. RESULTS: The IPA exhibited a statistically significant association with the NRS (τ = 0.58, P < 0.0001). Discordant answers were provided by 23.6% patients; 4.7% regarded their mild-to-moderate pain as intolerable (15/322) while 18.9% reported their severe pain as tolerable (61/322). Eighty-two percent of patients preferred the IPA. CONCLUSION: The IPA is a valid pain scale and has exhibited strong correlation with the NRS 0 to 10, displays simple minimally clinical important difference calculation, and provides meaningful information on the effect of pain control modulation.
介绍:本研究的目的是:(1) 构建一种能改善医患沟通的疼痛评估量表(干预性疼痛评估[IPA]工具);(2) 用数字评分法 0-10 数字评分系统(NRS)对新的疼痛量表进行验证。
方法:IPA 仅使用三个类别:0=“我没有疼痛”;1=“我的疼痛可以忍受(无需干预)”;2=“我的疼痛难以忍受(需要干预)”。对 322 例骨折治疗后康复的连续患者进行了机构审查委员会批准的研究。我们将 IPA 评分与 NRS 进行了比较。我们还询问了患者更喜欢哪种量表。统计分析包括 Kendall 等级相关(Kendall τ)和 Spearman rho 来确定与 NRS 的相关性。
结果:IPA 与 NRS 呈统计学显著相关性(τ=0.58,P<0.0001)。23.6%的患者给出了不一致的答案;4.7%(15/322)将其轻度至中度疼痛视为难以忍受,而 18.9%(61/322)则将其严重疼痛视为可忍受。82%的患者更喜欢 IPA。
结论:IPA 是一种有效的疼痛评估量表,与 NRS 0-10 具有很强的相关性,显示出简单的最小临床重要差异计算,并提供了关于疼痛控制调节效果的有意义的信息。
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