本文選題：疼痛 + 測量工具��； 參考：《廣州中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的：本研究旨在評估中國腰痛人群對疼痛測量工具應(yīng)答模式的選擇偏好,及這些測量工具在中國人群中的適用性；探索簡短版中醫(yī)健康量表(Short Form-Health Scale of Traditional Chinese Medicine, SF-HSTCM)在疼痛患者中的適用性和評價(jià)特性。方法：本研究從廣東省中醫(yī)院大德路總院骨科、按摩科、理療科、針灸科門診共計(jì)收集441例患有慢性腰痛的患者。通過橫斷面調(diào)查,研究多種形式的疼痛測量工具應(yīng)答模式在腰痛患者中的選擇偏好和適用性評價(jià),包括水平型視覺模擬量表(horizontal visual analogue scale, H-VAS),垂直型視覺模擬量表(vertical visual analogue scale, V-VAS)、數(shù)字評定量表(numerical rating scale, NRS)、詞匯疼痛強(qiáng)度量表(verbal pain intensity scale, VPIS)、面部表情量表(Wong-baker FACES pain rating scale, FACES scale);并以特異性腰痛測量工具羅蘭-莫里斯腰背痛問卷(Roland-Morris Disability Questionnaire, RMDQ)作為參照標(biāo)準(zhǔn)進(jìn)行相關(guān)性分析。同時采用SF-HSTCM評估慢性腰痛人群的健康狀態(tài),考評該量表在疼痛人群中的測量特性,并對其適用性進(jìn)行評估。采用描述性分析方法闡述多種形式的疼痛測量工具應(yīng)答模式的選擇偏好。采用相關(guān)性分析的方法來表述多種應(yīng)答模式測量工具與RMDQ的一致性。SF-HSTCM信度、效度分析分別主要采用克朗巴赫α系數(shù)法和證實(shí)性因子分析法進(jìn)行評價(jià)。結(jié)果：調(diào)查表的回收率為98.7%；多種形式疼痛測量工具量表、SF-HSTCM、RMDQ的應(yīng)答率分別為97.8%、97%、97.6%。H-VAS, V-VAS, NRS, SF-HSTCM和RMDQ的得分(X±SD)分別為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與RMDQ Pearson相關(guān)系數(shù)分別為0.416,0.426,0.418。VPIS及FACES scale與RMDQ Spearman相關(guān)系數(shù)為0.382和0.340。疼痛測量工具在首選位置的頻數(shù)排序?yàn)椋篎ACES scale (n=216); NRS (n=108); VPIS (n=89); H-VAS (n=15); V-VAS (n=6)。疼痛測量工具在前兩位累計(jì)被選擇頻數(shù)為：FACES scale (n=292); NRS (n=255); VPIS (n=228); H-VAS (n=64); V-VAS (n=29)。疼痛測量工具在前三位累計(jì)被選擇頻數(shù)為：VPIS (n=369); NRS (n=367); FACES scale (n=351); H-VAS (n=140); V-VAS (n=75).在75種排列組合中患者選擇頻數(shù)大于10的排列組合分別為：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分別代表NRS,H-VAS,VPIS,FACES scale以及V-VAS 。 SF-HSTCM的總內(nèi)在一致性Cronbach's α系數(shù)為0.914。SF-HSTCM奇、偶數(shù)條目兩部分Spearman-brown系數(shù)為0.763。SF-HSTCM各維度的內(nèi)在一致性為：社會環(huán)境領(lǐng)域(tASE) Cronbach's a系數(shù)為0.886,自然環(huán)境與人體機(jī)能領(lǐng)域(tPFNE) Cronbach'sα系數(shù)為0.826,精神意識思維領(lǐng)域(tSP) Cronbach's a系數(shù)為0.795,和人打交道能力方面(tACP) Cronbach's a系數(shù)為0.733,適應(yīng)自然環(huán)境能力方面(tANE) Cronbach'sα系數(shù)為0.625。SF-HSTCM收集的數(shù)據(jù)與量表的五個因子結(jié)構(gòu)模型之間進(jìn)行擬合檢驗(yàn),RMSEA為0.062,NNFI為0.96,GFI為0.88,CFI為0.96。結(jié)論：對于慢性腰痛的中國人群而言,在FACES scale、NRS、VPIS、H-VAS、V-VAS五種應(yīng)答模式中,FACES scale可能最易被接受,NRS、VPIS也相對比較適宜,但均與特異性腰痛評估量表RMDQ的相關(guān)性一般；SF-HSTCM在慢性腰痛患者有較好的信度,但在該類人群中其結(jié)構(gòu)效度擬合程度一般。本調(diào)查對于中國慢性腰痛人群選擇疼痛測量工具應(yīng)答模式具有參考價(jià)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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R681.55

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