Goldman Roberta E, Broderick Joan E, Junghaenel Doerte U, Bolton Alicia, May Marcella, Schneider Stefan, Stone Arthur A
Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Dornsife Center for Self-Report Science, University of Southern California, Los Angeles, CA, United States.
Front Pain Res (Lausanne). 2021 Aug 12;2:692567. doi: 10.3389/fpain.2021.692567. eCollection 2021.
Effective clinical care for chronic pain requires accurate, comprehensive, meaningful pain assessment. This study investigated healthcare providers' perspectives on seven pain measurement indices for capturing pain intensity. Semi-structured telephone interviews were conducted with a purposeful sample from four US regions of 20 healthcare providers who treat patients with chronic pain. The qualitative interview guide included open-ended questions to address perspectives on pain measurement, and included quantitative ratings of the importance of seven indices []. Qualitative interview data were read, coded and analyzed for themes and final interpretation. Standard quantitative methods were used to analyze index importance ratings. Despite concerns regarding 10-point visual analog and numeric rating scales, almost all providers used them. Providers most commonly asked about , although they expressed misgivings about patient reporting and the index's informational value. Some supplemented with and , and most believed pain intensity is best understood within the context of patient functioning. received the highest mean importance rating (7.60), the second lowest rating (5.65), and the lowest rating (5.20). Assessing intensity obviates obtaining clinical insight into daily contextual factors relating to pain and functioning. Pain index use, together with timing, functionality and disability, may be most effective for understanding the meaning to patients of high pain, how pain affects their life, how life affects their pain, and how pain changes and responds to treatment.
慢性疼痛的有效临床护理需要准确、全面且有意义的疼痛评估。本研究调查了医疗服务提供者对用于捕捉疼痛强度的七种疼痛测量指标的看法。对来自美国四个地区的20名治疗慢性疼痛患者的医疗服务提供者进行了有目的抽样的半结构化电话访谈。定性访谈指南包括开放性问题，以探讨对疼痛测量的看法，并包括对七个指标重要性的定量评分。对定性访谈数据进行阅读、编码和分析，以找出主题并进行最终解读。使用标准定量方法分析指标重要性评分。尽管对10分制视觉模拟评分法和数字评分法存在担忧，但几乎所有提供者都使用了它们。提供者最常询问[具体指标]，尽管他们对患者报告和该指标的信息价值表示疑虑。一些人用[其他指标]和[又一指标]进行补充，并且大多数人认为在患者功能的背景下最能理解疼痛强度。[某指标]获得了最高的平均重要性评分（7.60），[另一指标]获得了第二低的评分（5.65），而[再一指标]获得了最低的评分（5.20）。评估[某指标]强度排除了对与疼痛和功能相关的日常背景因素获得临床见解的可能性。疼痛指标的使用，连同时间、功能和残疾情况，可能对于理解高疼痛对患者的意义、疼痛如何影响他们的生活、生活如何影响他们的疼痛以及疼痛如何变化和对治疗作出反应最为有效。
