Baumermann Sonja V, Titze Christina, Hasenbring Monika I
Abteilung für Medizinische Psychologie und Medizinische Soziologie, Ruhr-Universität Bochum, Universitätsstraße 150, 44801, Bochum, Deutschland.
Schmerz. 2024 Sep 20. doi: 10.1007/s00482-024-00836-8.
Chronic pain affects an enormous number of patients in Germany. Therefore, early detection is important using easy, quick and reasonable screening methods. The avoidance-endurance fast screen is currently available in two different versions: one asking for pain-related behaviour in light and severe pain and the other assessing overall severe pain-related behaviour. In this study we aim to examine the agreement between both scales and for the first time describe the role of protective psychological features such as resilience and self-compassion in this model.
Epidemiological cross-sectional study (n = 278) of a healthy cohort occasionally experiencing pain (< 3 months). The analysis was done using standard descriptive statistics, correlations (Spearman's rho) and deductive statistics (t-tests and one-factor ANOVA with post hoc Bonferroni correction) and effect sizes (Cohen's d). Matching of the instruments was calculated with Cohen's kappa.
The results showed a moderate agreement for the two versions. A validity check of the subgroups resulted in comparable findings. The one-level version scored higher in terms of pain persistence which caused subgroup changes from adaptive to eustress-endurance responses and from fear-avoidance to distress-endurance responses. The distress-endurance subgroup had significantly lower values of the trait self-compassion.
Based on the results of this study, the quality of agreement between the two AEFS versions is considered strong. Without the comparison between mild and strong pain, endurance behaviour was reported more often. According to these findings, overestimation of pain persistence behaviour using the one-level version might result. Therefore, future studies should re-evaluate the cut-offs. As reported in previous studies, protective psychological features showed the highest scores in the eustress-endurance subgroup.
慢性疼痛影响着德国大量患者。因此，采用简便、快速且合理的筛查方法进行早期检测十分重要。目前，回避 - 耐力快速筛查有两种不同版本：一个询问轻度和重度疼痛时与疼痛相关的行为，另一个评估总体重度疼痛相关行为。在本研究中，我们旨在检验两种量表之间的一致性，并首次描述诸如心理韧性和自我同情等保护性心理特征在该模型中的作用。
对偶尔经历疼痛（<3个月）的健康队列进行流行病学横断面研究（n = 278）。分析采用标准描述性统计、相关性分析（斯皮尔曼等级相关系数）、演绎统计（t检验和经事后邦费罗尼校正的单因素方差分析）以及效应量（科恩d值）。用科恩kappa系数计算工具的匹配度。
结果显示两个版本之间具有中等一致性。对亚组的效度检验得出了类似的结果。单级版本在疼痛持续时间方面得分更高，这导致亚组从适应性反应转变为良性应激 - 耐力反应，从恐惧回避反应转变为痛苦 - 耐力反应。痛苦 - 耐力亚组的特质自我同情值显著更低。
基于本研究结果，两种回避 - 耐力快速筛查版本之间的一致性质量被认为较强。在不比较轻度和重度疼痛的情况下，更多地报告了耐力行为。根据这些发现，使用单级版本可能会高估疼痛持续行为。因此，未来的研究应该重新评估临界值。如先前研究报道，保护性心理特征在良性应激 - 耐力亚组中得分最高。
