Tanaka Yoichi, Fujii Ren, Shigetoh Hayato, Sato Gosuke, Morioka Shu
Department of Occupational Therapy, School of Rehabilitation, Hyogo Medical University, Hyogo, Japan.
Neuro Rehabilitation Research Center, Kio University, Nara, Japan.
J Pain Res. 2024 May 25;17:1929-1940. doi: 10.2147/JPR.S452790. eCollection 2024.
This study aimed to juxtapose the circadian rhythm of pain with the conventional 7-day assessment and ascertain the feasibility of condensing the evaluation of the circadian rhythm of pain into a 3-day timeframe.
Seventy-three patients with pain persisting for a minimum of 3 months and a numerical rating scale (NRS) score of ≥2 were recruited from three medical centers. The circadian patterns of pain were appraised over a 7-day period by quantifying the intensity of pain at six temporal junctures each day using a 10-cm visual analog scale (VAS). Cluster analysis was performed using six standardized variables derived from the VAS score of each participant at six designated time points to identify cohorts with analogous circadian rhythms of pain. The clusters were discerned for the 7- and 3-day assessments (Tuesday-Thursday, Friday-Sunday, and Sunday-Tuesday), according to the research objectives. Cohen's kappa coefficient was calculated to gauge the intra-observer variability to assess the consistency between the outcomes of the cluster analysis for the 7-day assessment and each of the 3-day assessments.
The highest Cohen's kappa coefficient was observed for the 3-day evaluation spanning from Friday to Sunday, indicating a substantial concordance with the results of the 7-day assessment.
Our results suggest that it may be prudent to consider implementing a condensed 3-day evaluation of the circadian rhythm of pain that is tailored to individual characteristics. This approach will allow a better understanding of the diurnal rhythms of chronic pain in patients and implement more targeted and specific pain management strategies. Furthermore, it will contribute to increased patient satisfaction through early intervention.
本研究旨在将疼痛的昼夜节律与传统的7天评估进行对比，并确定将疼痛昼夜节律评估浓缩至3天时间范围的可行性。
从三个医疗中心招募了73名疼痛持续至少3个月且数字评分量表（NRS）得分≥2的患者。通过使用10厘米视觉模拟量表（VAS），每天在六个时间节点量化疼痛强度，对疼痛的昼夜模式进行为期7天的评估。使用从每个参与者在六个指定时间点的VAS得分得出的六个标准化变量进行聚类分析，以识别具有相似疼痛昼夜节律的队列。根据研究目标，对7天和3天评估（周二至周四、周五至周日以及周日至周二）的聚类进行识别。计算科恩kappa系数以衡量观察者内变异性，评估7天评估与各3天评估的聚类分析结果之间的一致性。
在从周五至周日的3天评估中观察到最高的科恩kappa系数，表明与7天评估结果高度一致。
我们的结果表明，考虑实施针对个体特征量身定制的疼痛昼夜节律3天浓缩评估可能是谨慎之举。这种方法将有助于更好地理解患者慢性疼痛的昼夜节律，并实施更具针对性和特异性的疼痛管理策略。此外，通过早期干预将有助于提高患者满意度。
