Skevington Suzanne M
W.H.O. Centre for the Study of Quality of Life, University of Bath, Bath BA2 7AY, UK.
Pain. 1998 Jun;76(3):395-406. doi: 10.1016/S0304-3959(98)00072-4.
The aim of this study was to examine the impact of pain on quality of life and its components in a representative sample of 320 well people, and patients selected from all major categories of illness. Quality of life was assessed using a new, multidimensional, multilingual, generic profile designed for cross-cultural use in health care, i.e. the WHOQOL. Within the WHOQOL, pain and discomfort is one of 29 areas or facets of quality of life, grouped into six domains. It was found that pain and discomfort made a significant impact on perceptions of general quality of life related to health. Furthermore, the presence of pain affected perceptions of five of the six domains of quality of life; the domain of spirituality, religion and personal beliefs being the exception. When quality of life is assessed, negative feelings are most closely associated with reports of pain and discomfort than any other facet. But quality of life surrounding pain and discomfort is more fully explained by the inclusion of six additional facets; the availability of social care, mobility, activities of daily living, positive mood and to a lesser extent, sleep and dependence on medication. Together, these seven facets represent criteria against which the success of pain treatments may be evaluated. As predicted, those who were pain-free had significantly better quality of life than those in pain. A longer duration of pain is associated with increasingly poorer quality of life. Intense affective pain is particularly detrimental to a good quality of life. The psychometric properties of the pain and discomfort facet of the WHOQOL and WHOQOL-100 were assessed. Internal consistency (reliability), discriminant and criterion/concurrent validity were found to be good to excellent, justifying the use of this instrument with a range of chronic and acute pain patients.
本研究旨在考察疼痛对320名健康人群以及从所有主要疾病类别中选取的患者这一代表性样本的生活质量及其组成部分的影响。生活质量采用一种新的、多维度、多语言、适用于医疗保健跨文化使用的通用量表进行评估，即世界卫生组织生活质量量表（WHOQOL）。在WHOQOL中，疼痛与不适是生活质量的29个方面或维度之一，分为六个领域。研究发现，疼痛与不适对与健康相关的总体生活质量认知有显著影响。此外，疼痛的存在影响了生活质量六个领域中的五个领域的认知；精神、宗教和个人信仰领域除外。在评估生活质量时，负面情绪与疼痛和不适报告的关联比与任何其他方面的关联都更为密切。但是，通过纳入另外六个方面，可以更全面地解释围绕疼痛与不适的生活质量；这六个方面包括社会护理的可获得性、行动能力、日常生活活动、积极情绪，以及在较小程度上的睡眠和对药物的依赖。这七个方面共同构成了评估疼痛治疗成功与否的标准。正如所预测的，无痛者的生活质量明显优于疼痛患者。疼痛持续时间越长，生活质量越差。强烈的情感性疼痛对良好的生活质量尤其有害。对WHOQOL和WHOQOL - 100中疼痛与不适维度的心理测量特性进行了评估。发现内部一致性（信度）、区分效度和标准/同时效度良好至优秀，证明该量表适用于一系列慢性和急性疼痛患者。
