疼痛門診病人的心裡社會特性和疼痛強度有相關性

Psychosocial Characteristics Are Related to the Pain Intensity in Pain Clinic Patients

背景：心理社會因子可能會跟疼痛強度有相關性，而且是處理病人疼痛時不可缺少的環節。我們設計一個問卷分析疼痛門診的病人的疼痛強度是否和病人心裡社會因素有關：試圖尋找一個心理社會因子是疼痛強度的最佳指標。並且分析在不同的診斷類別的病人之中，心理社會園子和疼痛強度是否會有差異。方法：從2004年2月到2006年1月之間的疼痛門診初診病人，以問卷調查的方式，總共有五項心裡社會因子列入分析：睡眠品質，食慾，日常活動，注意力以及人際關係。並分析不同診斷類別的病人是否有不同。結果：569位病人之中無論是否有紀錄疼痛強度（有紀錄300位，無紀錄269位病人）皆納入分析。我們的結果指出疼痛強度和心裡社會因子：睡眠品質，食慾，日常活動以及注意力有相關性。但線性回歸分析指出只有日常活動與疼痛強度有關。瘖症病人的各項生活品質指數都比其他類診斷的病人低，肌筋膜炎的病人則較佳。結論：疼痛強度跟睡眠品質，食慾，日常活動以及注意力都有關連性。瘖症病人的各項生活品質指數都比其他類診斷的病人低，在治療箔症病人的疼痛時吾人尤其應該一併將病人的生活品質指標列入考量。

Background: Psychological or social factors are essential aspects of pain management. We conducted a retrospective study analyzing whether patients' pain intensity corresponded to psychosocial factors or whether any psychosocial factors waswere correlateds for evaluation in pain intensity. Furthermore, we tried to find out whether the correlation between pain intensity and psychosocial factors was related to diagnostic categories. Methods: Those patients for their first visiting our pain clinic timefrom Feb 2004 to Jan 2006 were included. A questionnaire was given to the patient before a doctor' s interview. Five psychosocial factors, of quality of sleep, appetite, daily activity, concentration and social interaction, were included for analyseis. Pain intensity was recorded using numerical rating pain scale. Results: Total 568 patients with (patient number: 300) or without (patient number 268) pain intensity recording were all included in this study. Pain intensity was correlated with 4 psychosocial factors : quality of sleep, appetite, daily activity and concentration. The result from linear regression (after dummy code recoded) reveals that only daily activity factors had influence on pain intensity (R2 = 0.076,p = 0.001). Quality of sleep had no significant influence on pain intensity (p=0.068). Patients with cancer pain had demonstrated the worst psychosocial manifestation. Patients with myofascial pain presented least psychosocial manifestation. Conclusion: Pain intensity is correlated to quality of sleep, appetite, daily activity, and concentration. Among various diagnostic categories, cancer patients need more our effort for their pain-associated conditions.