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[慢性疼痛分级量表在非特异性慢性下腰痛中的效度]

[Validity of the Chronic Pain Grade Scale in nonspecific chronic low back pain].

作者信息

Hampel Petra, Hüwel Anna Maria

机构信息

Institut für Gesundheits- und Ernährungswissenschaften, Europa-Universität Flensburg, Auf dem Campus 1, 24943, Flensburg, Deutschland.

出版信息

Schmerz. 2024 Nov 7. doi: 10.1007/s00482-024-00844-8.

Abstract

BACKGROUND

Higher pain grades are associated with high psychological burden and increase the risk for the persistence of chronic low back pain (CLBP).

OBJECTIVES

Previous results on the criterion validity of the Chronic Pain Grade Scale (CPGS) have been extended to the context of inpatient multidisciplinary orthopedic rehabilitation (MOR) and have been supplemented with additional psychosocial and work-related measures.

METHODS

In this multicenter study, psychological, work- and pain-related outcomes were examined among 1010 individuals with nonspecific CLBP (ICD-10: M51/53/54) prior to the beginning of an inpatient MOR stratified by pain grade (I-IV). Additionally, frequency distributions of scores regarding pain-specific self-efficacy, depression, and subjective prognosis of gainful employment by pain grade in patients were investigated.

RESULTS

The CPGS differed between all pain grades in the psychological, work- and pain-related outcomes in the expected direction. In post hoc pairwise comparisons, grade IV was significantly different from the lower grades. Patients with higher pain grades showed unfavorable levels in psychosocial parameters and more frequently scores in the clinical range than expected.

CONCLUSIONS

These results confirm the criterion validity of the CPGS. The psychosocial risk pattern observed in higher pain grades supports the importance of conducting early pain-related and psychological diagnostic assessments and implementing systematic allocation to needs-based interdisciplinary multimodal treatments.

摘要

背景

较高的疼痛等级与高心理负担相关,并增加慢性下腰痛(CLBP)持续存在的风险。

目的

先前关于慢性疼痛等级量表(CPGS)标准效度的结果已扩展到住院多学科骨科康复(MOR)背景下,并补充了额外的社会心理和工作相关测量指标。

方法

在这项多中心研究中,对1010名非特异性CLBP(国际疾病分类第十版:M51/53/54)患者在住院MOR开始前按疼痛等级(I-IV)分层,检查其心理、工作和疼痛相关结局。此外,还调查了患者按疼痛等级划分的疼痛特异性自我效能、抑郁和有酬就业主观预后得分的频率分布。

结果

CPGS在心理、工作和疼痛相关结局的所有疼痛等级之间按预期方向存在差异。在事后两两比较中,IV级与较低等级有显著差异。疼痛等级较高的患者在社会心理参数方面表现出不利水平,且临床范围内的得分比预期更频繁。

结论

这些结果证实了CPGS的标准效度。在较高疼痛等级中观察到的社会心理风险模式支持进行早期疼痛相关和心理诊断评估以及实施基于需求的跨学科多模式治疗系统分配的重要性。

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