門診慢性疼痛病人日常生活功能及心理社會功能障礙之評估

The Functional Assessment of Chronic Pain Patients Activity of Daily Living and Psychosocial Disability

楊美賞(Mei-Sang Yang) ； 曾清楷(Chin-Kai Tseng) ； 鍾信心(Hsin-Hsing Chung) ； 葉宏軒(Wang-Hin Yip)

《The Kaohsiung Journal of Medical Sciences》 8卷10期 (1992/10) Pp. 552-561

https://doi.org/10.6452/KJMS.199210.0552

摘要

為了解慢性疼痛病人在面對長期的疼痛痛苦之後，其日常生活及心理社會功能改變的情形，本研究利用會談及二種結構式問卷(疾病衝擊量表及台大症狀量表)來評量111位慢性疼痛病人功能障礙的情況。結果顯示慢性疼痛病人的身體、心理社會、工作、娛樂方面有明顯的功能障礙，而且也發現病人心理社會功能比身體功能障礙嚴重，與對照組比較，結果發現病人有明顯的身體化症狀及憂鬱、焦慮之情緒反應。利用複迴歸分析的結果發現，病人的性別、年齡、教育程度、疾病診斷、就業狀態、疼痛程度及疼痛的期間為影響病人日常生活功能及身心症狀之重要因素。此外，本研究的結果亦支持疾病衝擊量表是評量慢性疼痛病人功能狀態的有效工具，特別是疾病衝擊量表評量病人心理社會功能障礙的結果與台大症狀量表所評量之結果有顯著性的相關，由於本表之信度、效度、評估廣度均佳，且易於填答，故可做為慢性疼痛病人功能狀態及多元化疼痛醫療單位醫療效果評估之工具。

並列摘要

The purpose of this study was to investigate the impact of activity of daily living and psychosocial function in patients with chronic nonmalignant pain. From Jun. 1989 to Nov.1989, one hundred and eleven cases were assessed by Sickness Impact Profile (SIP) and Taita Symptom Check List (TSCL) to evaluate the disabilities associated with chronic pain. Patients showed significant impairment in the functions of physical psychosocial work and recreational activities. It was also apparent the the psychosocial diabilities were more severe than physical disabilities. Specifically, they showed anxiety depression and significant somatization. Analysis by stepwise multiple regression indicates that sex’age’education level’employment status’diagnosis and pain intensity were the significant influencing factors related to the disabilities of activity of daily living and psychosocial function. The results supported the validity of the SIP as a measurement of functional status with chronic pain patients. Specifically, the psychosocial dimension was significantly correlated with the psychological and psychosocial distress categories of the TSCL. Based upon its reliability’validity’breadth of assessment and ease of administration, the SIP appeared to be well suited for the assessment of patients with chronic pain and for evaluating the efficacy of multidisciplinary pain treatment.

並列關鍵字

chronic pain ； psychosocial function ； activity of daily living