RISK-FACTORS OF CHRONICITY IN LUMBAR DISC PATIENTS - A PROSPECTIVE INVESTIGATION OF BIOLOGIC, PSYCHOLOGIC, AND SOCIAL PREDICTORS OF THERAPY OUTCOME
RISK-FACTORS OF CHRONICITY IN LUMBAR DISC PATIENTS - A PROSPECTIVE INVESTIGATION OF BIOLOGIC, PSYCHOLOGIC, AND SOCIAL PREDICTORS OF THERAPY OUTCOME
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DOI：
10.1097/00007632-199412150-00004
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发表时间：
1994-12-15
期刊：
影响因子：
3
通讯作者：
SOYKA, D
中科院分区：
文献类型：
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作者：
HASENBRING, M;MARIENFELD, G;SOYKA, D
研究设计。目前的前瞻性纵向研究检查了心理、躯体和社会变量对连续选择的 111 名患有急性根性疼痛和腰椎间盘脱垂或突出的患者的短期和长期随访预测的预测价值。 目的。治疗结果的标准是出院时和6个月后持续疼痛的强度以及6个月随访时申请提前退休。方法。至于心理预测因素，我们检查了抑郁症（贝克抑郁量表 BDI）、日常麻烦（基尔主观情境访谈 KISS）、疼痛应对策略（基尔疼痛量表 KSI）和健康控制点（GKU）。作为躯体预测因素，我们评估了治疗前的疼痛持续时间、既往手术、轻瘫、椎间盘移位、脊柱侧凸、肥胖、治疗和年龄。作为社会预测因素，我们评估了社会地位、职业特征和无法工作的持续时间。结果。结果表明，通过结合躯体（椎间盘移位程度）、心理（抑郁和疼痛应对策略、回避行为、耐力策略、非语言疼痛行为和寻求社会支持）和社会参数（社会地位和坐姿）来最好地预测持续性疼痛，预测正确率为 86%。 6 个月随访时提前退休的申请最能通过工作中的抑郁和压力来预测。结论。结果得出了关于根性疼痛慢性化中生物心理社会相互关系的几种假设，并为临床医生提供了早期诊断慢性化的简短筛查工具。
Study Design. The current prospective longitudinal study examined the predictive value of psychological, somatic and social variables for the prediction of the short- and long-term follow-up in 111 consecutively selected patients with acute radicular pain and a lumbar disc prolapse or protrusion.Objectives. The criteria for the therapy outcome were the intensity of persistent pain at the time of the discharge from the hospital and 6 months later and the application for early retirement at the 6 month follow-up.Methods. As for the psychological predictors, we examined depression (Beck Depression Inventory BDI), daily hassles (Kiel Interview of the Subjective Situation KISS), pain coping strategies (Kiel Pain Inventory KSI), and Health locus of control (GKU). As somatic predictors, we assessed the duration of pain before treatment, previous operations, paresis, disc displacement, scoliosis, adipositas, treatment, and age. As social predictors, we assessed the social status, occupational characteristics, and the duration of inability to work.Results. The results indicated that persistent pain was best predicted by a combination of somatic (degree of disc displacement), psychological (depression and the pain coping strategies avoidance behavior, endurance strategies, nonverbal pain behavior and search for social for social support), and social parameters (social status and sitting position) with a correct prediction in 86%. The application for early retirement at the 6 month follow-up was best predicted by depression and stress at work.Conclusions. The results lead to several hypotheses about biopsychosocial interrelations within the chronification of radicular pain and provide the clinician with a short screening instrument for early diagnosis of chronification.