Turk D C, Wack J T, Kerns R D
J Behav Med. 1985 Jun;8(2):119-30. doi: 10.1007/BF00845516.
Observable means of communicating pain and suffering, "pain behaviors," have been postulated to comprise an important construct relevant in both the development and the maintenance of chronic pain [Fordyce, W.E. (1976). Behavioral Methods for Chronic Pain and Illness, C.V. Mosby, St. Louis, Mo.]. Two groups of professionals who have direct contact with chronic-pain patients (i.e., physicians and psychologists) participated in a study designed (a) to identify the latent or underlying characteristics of pain behaviors and (b) to assess the degree of agreement of these characteristics between health professionals with very different training. Multi-dimensional scaling and hierarchical clustering statistical techniques were employed to identify the latent structure of pain behaviors. Two primary pain behavior dimensions were identified, namely, audible-visible and affective-behavioral. Four clusters of pain behaviors were identified and labeled distorted ambulation or posture, negative affect, facial/audible expressions of distress, and avoidance of activity. The two samples of health-care providers identified virtually equivalent latent characteristics of pain behaviors. The data suggest that there is consistency in the pain-behavior construct and that the latent structure is generally congruent with Fordyce's original conceptualization. The results provide an empirically derived basis for the assessment of pain behaviors.
传达疼痛和痛苦的可观察方式，即“疼痛行为”，被假定为一个重要的概念，与慢性疼痛的发展和维持都相关[福代斯，W.E.（1976年）。《慢性疼痛和疾病的行为方法》，C.V.莫斯比出版社，密苏里州圣路易斯]。两组与慢性疼痛患者有直接接触的专业人员（即医生和心理学家）参与了一项研究，该研究旨在（a）确定疼痛行为的潜在或基本特征，以及（b）评估接受非常不同培训的健康专业人员之间对这些特征的一致程度。采用多维尺度分析和层次聚类统计技术来确定疼痛行为的潜在结构。确定了两个主要的疼痛行为维度，即听觉-视觉维度和情感-行为维度。确定并标记了四组疼痛行为，即步态或姿势扭曲、消极情绪、痛苦的面部/听觉表达以及活动回避。两组医疗保健提供者样本确定了几乎相同的疼痛行为潜在特征。数据表明，疼痛行为概念具有一致性，且潜在结构通常与福代斯的原始概念一致。这些结果为疼痛行为的评估提供了基于实证的依据。
