Graded chronic pain scale revised: mild, bothersome, and high-impact chronic pain
Graded chronic pain scale revised: mild, bothersome, and high-impact chronic pain
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DOI：
10.1097/j.pain.0000000000001758
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发表时间：
2020-03-01
期刊：
影响因子：
7.4
通讯作者：
Keefe, Francis J.
中科院分区：
文献类型：
--
作者：
Von Korff, Michael;DeBar, Lynn L.;Keefe, Francis J.
借助慢性疼痛衡量指标方面的进展，开发了一种简化的修订版慢性疼痛分级量表，用于区分轻度、令人困扰的和高影响的慢性疼痛。修订版慢性疼痛分级量表在两个健康计划的成年参保人（N = 2021）中得到了验证。在这一人群中，慢性疼痛（过去3个月中大部分时间或每天都有疼痛）的患病率为40.5%：15.4%为轻度慢性疼痛（疼痛强度和干扰较低）；10.1%为令人困扰的慢性疼痛（中到重度疼痛强度，但对生活活动的干扰较低）；15.0%为高影响慢性疼痛（持续的与疼痛相关的活动受限）。轻度慢性疼痛患者与无慢性疼痛者在10项健康状况指标（不良健康认知、活动受限和接受长期阿片类药物治疗）上显示出较小差异，其中10项指标中有7项差异不显著。令人困扰的慢性疼痛患者与轻度慢性疼痛患者在10项指标中的6项上有显著差异（例如，消极的疼痛应对信念、心理困扰、不良健康认知以及与疼痛相关的对整体活动的干扰）。高影响慢性疼痛患者与轻度慢性疼痛患者在所有10项指标上都有显著差异。与令人困扰的慢性疼痛患者相比，高影响慢性疼痛患者更有可能有严重的活动受限（5项残疾指标中有4项有显著差异），并且更经常接受长期阿片类药物治疗。修订版慢性疼痛分级量表对5项活动受限指标有很强的预测能力，受试者工作特征曲线下面积系数为0.76到0.89。我们得出结论，包含5个项目的修订版慢性疼痛分级量表及其评分规则为评估慢性疼痛提供了一种简洁、简单且有效的方法。
Drawing on advances in chronic pain metrics, a simplified Graded Chronic Pain Scale-Revised was developed to differentiate mild, bothersome, and high-impact chronic pain. Graded Chronic Pain Scale-Revised was validated among adult enrollees of 2 health plans (N = 2021). In this population, the prevalence of chronic pain (pain present most or every day, prior 3 months) was 40.5%: 15.4% with mild chronic pain (lower pain intensity and interference); 10.1% bothersome chronic pain (moderate to severe pain intensity with lower interference with life activities); and 15.0% high-impact chronic pain (sustained pain-related activity limitations). Persons with mild chronic pain vs those without chronic pain showed small differences on 10 health status indicators (unfavorable health perceptions, activity limitations, and receiving long-term opioid therapy), with nonsignificant differences for 7 of 10 indicators. Persons with bothersome vs mild chronic pain differed significantly on 6 of 10 indicators (eg, negative pain coping beliefs, psychological distress, unfavorable health perceptions, and pain-related interference with overall activities). Persons with high-impact chronic pain differed significantly from those with mild chronic pain on all 10 indicators. Persons with high-impact chronic pain, relative to those with bothersome chronic pain, were more likely to have substantial activity limitations (significant differences for 4 of 5 disability indicators) and more often received long-term opioid therapy. Graded Chronic Pain Scale-Revised strongly predicted 5 activity-limitation indicators with area under receiver operating characteristic curve coefficients of 0.76 to 0.89. We conclude that the 5-item Graded Chronic Pain Scale-Revised and its scoring rules provide a brief, simple, and valid method for assessing chronic pain.