Comparing Perceived Pain Impact Between Younger and Older Adults With High Impact Chronic Pain: A Cross-Sectional Qualitative and Quantitative Survey.
Comparing Perceived Pain Impact Between Younger and Older Adults With High Impact Chronic Pain: A Cross-Sectional Qualitative and Quantitative Survey.
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DOI：
10.3389/fpain.2022.850713
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发表时间：
2022
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高冲击性慢性疼痛（HICP）是最近提出的一个概念，用于对慢性疼痛患者进行分层并监测其进展。目的是减少慢性疼痛对个人、家庭和社会的影响。美国国家疼痛战略将HICP定义为与参与工作，社交和自我护理活动至少6个月的实质性限制相关的慢性疼痛。为了了解年轻（<65岁）和老年（≥65岁）慢性疼痛患者HICP的意义和特征，我们的研究检查了两个年龄组之间患者的疼痛影响感知。我们还描述了疼痛影响的程度，评估与患者报告的结果测量信息系统（PROMIS）疼痛干扰（PI），成人和老年人之间的HICP。我们在一家三级疼痛诊所招募病人。该调查包括关于疼痛影响的开放式问题、慢性疼痛分级量表-修订版（以确定患者是否符合HICP标准）和患者报告结局测量信息系统（PROMIS®）8项PI简表（v.8a）。共有55名患有慢性疼痛的年轻成人（65.5%女性，72.7% HICP，平均年龄= 55.0，SD为16.2）和28名患有慢性疼痛的老年成人（53.6%女性，64.3% HICP，平均年龄= 72.6，SD为5.4）参加了本研究。在回答一个开放式问题时，参与者被要求列出主要影响疼痛的领域，年轻组中的HICP患者最常列出的是工作，社交活动和基本体力活动（例如，行走和站立）;对于老年组中的那些，基本的身体活动，日常生活的工具性活动（例如，家务劳动、杂货店购物）和参加社交或娱乐活动是HICP老年人最常见的。使用年龄（年轻人vs.老年人）和HICP分类（HICP vs.无HICP）进行2 × 2 ANOVA。不同HICP状态的PROMIS-PI T评分存在统计学显著差异（HICP：M = 58.4，SD = 6.3;无HICP：M = 67.8，SD = 6.3），但不同HICP年龄组的差异不显著。总之，感知疼痛的影响是定性的，但没有定量的不同，年轻人和老年人与HICP。我们讨论了局限性，并为未来的研究提供了建议。
High impact chronic pain (HICP) is a recently proposed concept for treatment stratifying patients with chronic pain and monitoring their progress. The goal is to reduce the impact of chronic pain on the individual, their family, and society. The US National Pain Strategy defined HICP as the chronic pain associated with substantial restrictions on participation in work, social, and self-care activities for at least 6 months. To understand the meaning and characteristics of HICP from the younger (<65 years old) and older adults (≥65 years old) with chronic pain, our study examined patients' perceived pain impact between the two age groups. We also characterize the degree of pain impact, assessed with the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (PI), between adults and older adults with HICP. We recruited patients at a tertiary pain clinic. The survey included open-ended questions about pain impact, the Graded Chronic Pain Scale-Revised to identify patients' meeting criteria for HICP, and the Patient-Reported Outcomes Measurement Information System (PROMIS®) 8-item PI short form (v.8a). A total of 55 younger adults (65.5% women, 72.7% HICP, mean age = 55.0 with SD of 16.2) and 28 older adults (53.6% women, 64.3% HICP, mean age = 72.6 with SD of 5.4) with chronic pain participated in this study. In response to an open-ended question in which participants were asked to list out the areas of major impact pain, those with HICP in the younger group most commonly listed work, social activity, and basic physical activity (e.g., walking and standing); for those in the older group, basic physical activity, instrumental activity of daily living (e.g., housework, grocery shopping), and participating in social or fun activity for older adults with HICP were the most common. A 2 × 2 ANOVA was conducted using age (younger adults vs. older adults) and HICP classification (HICP vs. No HICP). A statistically significant difference was found in the PROMIS-PI T-scores by HICP status (HICP: M = 58.4, SD = 6.3; No HICP: M = 67.8, SD = 6.3), but not by age groups with HICP. In conclusion, perceived pain impacts were qualitatively, but not quantitatively different between younger and older adults with HICP. We discuss limitations and offer recommendations for future research.
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