Toomey Timothy C, Gover Virginia F, Jones Beverly N
University of North Carolina Pain Center, Dental Research Unit, Chapel Hill, NC 27514 U.S.A.
Pain. 1984 Aug;19(4):389-397. doi: 10.1016/0304-3959(84)90085-X.
Recent research has focused on identification of clinically meaningful subgroupings within the chronic pain population in contrast to prior emphasis on the homogeneity of these patients. The present study investigates site of pain as a potentially useful classification variable for identification of differences among chronic pain patients. In the study 92 patients presenting to a multidisciplinary pain clinic with chronic, benign pain were categorized as to site of pain (head/neck, low back, neither, both). Patients completed self-report scales assessing various activity abilities and health behaviors, a measure of pain description (McGill Pain Questionnaire (MPQ), health related measures of personality (Illness Behavior Questionnaire (IBQ) and health beliefs (Multidimensional Health Locus of Control (MHLC). One-way ANOVAs revealed significant differences as a function of pain site on a number of behavioral variables (downtime, walking, recreational and social abilities), pain description (MPQ--number of words chosen, total sum of ranks, sensory and affective) and psychological variables (IBQ--disease conviction, psychologic vs. somatic perception of illness and MHLC--internality). These results suggest site of pain to be of significance in the elaboration of behavioral and psychological response to chronic pain and implications for treatment are discussed.
与之前对这些患者同质性的强调不同，最近的研究集中在慢性疼痛人群中具有临床意义的亚组识别上。本研究调查疼痛部位作为识别慢性疼痛患者差异的一个潜在有用的分类变量。在该研究中，92名因慢性良性疼痛前往多学科疼痛诊所就诊的患者按照疼痛部位（头部/颈部、下背部、都不是、两者都有）进行了分类。患者完成了自我报告量表，评估各种活动能力和健康行为、一种疼痛描述测量工具（麦吉尔疼痛问卷（MPQ））、与健康相关的人格测量工具（疾病行为问卷（IBQ））以及健康信念（多维健康控制点（MHLC））。单因素方差分析显示，在一些行为变量（休息时间、行走、娱乐和社交能力）、疼痛描述（MPQ——所选单词数量、总排名、感觉和情感）以及心理变量（IBQ——疾病确信度、对疾病的心理与躯体感知以及MHLC——内控性）方面，作为疼痛部位的函数存在显著差异。这些结果表明疼痛部位在阐述对慢性疼痛的行为和心理反应方面具有重要意义，并对治疗的影响进行了讨论。
