疼痛测量工具应答模式在腰痛人群中的适用性研究

发布时间：2018-05-16 21:37

本文选题：疼痛 + 测量工具　；参考：《广州中医药大学》2015年硕士论文

【摘要】：目的：本研究旨在评估中国腰痛人群对疼痛测量工具应答模式的选择偏好,及这些测量工具在中国人群中的适用性；探索简短版中医健康量表(Short Form-Health Scale of Traditional Chinese Medicine, SF-HSTCM)在疼痛患者中的适用性和评价特性。方法：本研究从广东省中医院大德路总院骨科、按摩科、理疗科、针灸科门诊共计收集441例患有慢性腰痛的患者。通过横断面调查,研究多种形式的疼痛测量工具应答模式在腰痛患者中的选择偏好和适用性评价,包括水平型视觉模拟量表(horizontal visual analogue scale, H-VAS),垂直型视觉模拟量表(vertical visual analogue scale, V-VAS)、数字评定量表(numerical rating scale, NRS)、词汇疼痛强度量表(verbal pain intensity scale, VPIS)、面部表情量表(Wong-baker FACES pain rating scale, FACES scale);并以特异性腰痛测量工具罗兰-莫里斯腰背痛问卷(Roland-Morris Disability Questionnaire, RMDQ)作为参照标准进行相关性分析。同时采用SF-HSTCM评估慢性腰痛人群的健康状态,考评该量表在疼痛人群中的测量特性,并对其适用性进行评估。采用描述性分析方法阐述多种形式的疼痛测量工具应答模式的选择偏好。采用相关性分析的方法来表述多种应答模式测量工具与RMDQ的一致性。SF-HSTCM信度、效度分析分别主要采用克朗巴赫α系数法和证实性因子分析法进行评价。结果：调查表的回收率为98.7%；多种形式疼痛测量工具量表、SF-HSTCM、RMDQ的应答率分别为97.8%、97%、97.6%。H-VAS, V-VAS, NRS, SF-HSTCM和RMDQ的得分(X±SD)分别为51.12±21.75,48.50±22.56,5.24±2.06,61.74±14.3以及8.96±5.09。H-VAS, V-VAS, NRS与RMDQ Pearson相关系数分别为0.416,0.426,0.418。VPIS及FACES scale与RMDQ Spearman相关系数为0.382和0.340。疼痛测量工具在首选位置的频数排序为：FACES scale (n=216); NRS (n=108); VPIS (n=89); H-VAS (n=15); V-VAS (n=6)。疼痛测量工具在前两位累计被选择频数为：FACES scale (n=292); NRS (n=255); VPIS (n=228); H-VAS (n=64); V-VAS (n=29)。疼痛测量工具在前三位累计被选择频数为：VPIS (n=369); NRS (n=367); FACES scale (n=351); H-VAS (n=140); V-VAS (n=75).在75种排列组合中患者选择频数大于10的排列组合分别为：dacbe (n=61)、dcabe (n=51)、cdabe (n=25)、acdbe (n=23)、 adcbe (n=19)、cadbe (n=17)、dcaeb (n=17)、daceb (n=16)、abcde (n=10)、adced (n=10) (a, b, c,d, e分别代表NRS,H-VAS,VPIS,FACES scale以及V-VAS 。 SF-HSTCM的总内在一致性Cronbach's α系数为0.914。SF-HSTCM奇、偶数条目两部分Spearman-brown系数为0.763。SF-HSTCM各维度的内在一致性为：社会环境领域(tASE) Cronbach's a系数为0.886,自然环境与人体机能领域(tPFNE) Cronbach'sα系数为0.826,精神意识思维领域(tSP) Cronbach's a系数为0.795,和人打交道能力方面(tACP) Cronbach's a系数为0.733,适应自然环境能力方面(tANE) Cronbach'sα系数为0.625。SF-HSTCM收集的数据与量表的五个因子结构模型之间进行拟合检验,RMSEA为0.062,NNFI为0.96,GFI为0.88,CFI为0.96。结论：对于慢性腰痛的中国人群而言,在FACES scale、NRS、VPIS、H-VAS、V-VAS五种应答模式中,FACES scale可能最易被接受,NRS、VPIS也相对比较适宜,但均与特异性腰痛评估量表RMDQ的相关性一般；SF-HSTCM在慢性腰痛患者有较好的信度,但在该类人群中其结构效度拟合程度一般。本调查对于中国慢性腰痛人群选择疼痛测量工具应答模式具有参考价值。
[Abstract]:Objective: the purpose of this study was to evaluate the selection preference of Chinese low back pain response model for pain measurement tools, and the applicability of these tools in Chinese population, and to explore the applicability and evaluation characteristics of Short Form-Health Scale of Traditional Chinese Medicine (SF-HSTCM) in patients with pain. Methods: 441 patients with chronic low back pain were collected from Department of orthopedics, chiropractic, physiotherapy and acupuncture and moxibustion Department of DDD General Hospital of Guangdong Province Traditional Chinese Medical Hospital. Through cross-sectional investigation, the selection of response patterns of various forms of pain measurement tools in patients with low back pain was better and applicable, including the level of visual analog. The horizontal visual analogue scale (H-VAS), the vertical visual analogue scale (vertical visual analogue scale, V-VAS), the digital Rating Scale (numerical rating), the vocabulary pain intensity scale, and the surface facial expression scale. Roland-Morris Disability Questionnaire (RMDQ) was used as a reference for the correlation analysis of the heterosexual low back pain measurement instrument (Roland-Morris Questionnaire, RMDQ). At the same time, the health status of the people with chronic low back pain was assessed and the measurement specificity of the scale in the pain population was evaluated and its applicability was evaluated. The method of correlation analysis was used to express the consistency.SF-HSTCM reliability of multiple response pattern measurement tools and RMDQ, and the validity analysis was evaluated by Krone Bach alpha coefficient method and confirmatory factor analysis. The yield was 98.7%, and the response rates of various forms of pain measurement tools, SF-HSTCM, and RMDQ were 97.8%, 97%, 97.6%.H-VAS, V-VAS, NRS, SF-HSTCM and RMDQ respectively (X + SD) were 51.12 + 21.75,48.50 + 22.56,5.24 + 14.3 and 8.96 +. The frequency of the correlation coefficient of VPIS and FACES scale and RMDQ Spearman is 0.382 and 0.340. pain measurement tools in the preferred location: FACES scale (n=216); NRS (n=108); VPIS. S (n=64); V-VAS (n=29). The cumulative number of pain measuring tools in the first three places is VPIS (n=369); NRS (n=367); FACES scale (n=351); H-VAS. ADBE (n=17), dcaeb (n=17), daceb (n=16), ABCDE (n=10), adced (n=10). The Cronbach's a coefficient of tASE was 0.886, the Cronbach's alpha coefficient of natural environment and human function field (tPFNE) was 0.826, the Cronbach's a coefficient of mental consciousness field (tSP) was 0.795, and the Cronbach's a coefficient of human being (tACP) Cronbach's a was 0.733. CM collected data and the five factor structural model of the scale, RMSEA was 0.062, NNFI was 0.96, GFI was 0.88, and CFI was 0.96. conclusion: for Chinese people with chronic low back pain, in FACES scale, NRS, VPIS, H-VAS, V-VAS five responses may be most acceptable, but relatively suitable, but also relatively appropriate, but The correlation is generally with the specific low back pain assessment scale (RMDQ); SF-HSTCM has a good reliability in patients with chronic low back pain, but its structural validity is generally fitted in this class of people. This survey has a reference value for the choice of the response model of pain measurement tools for chronic low back pain in China.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.55

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