Measurement of acute postoperative pain intensity in orthopedic trials: a qualitative concept elicitation study.

IF 2.5 2区 医学 Q1 ORTHOPEDICS Acta Orthopaedica Pub Date : 2024-11-07 DOI:10.2340/17453674.2024.42182
Karen T Bjørnholdt, Carina W G Andersen
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Abstract

Background and purpose: Pain intensity is an important outcome in clinical trials of surgery because pain relief is important to patients. Currently, recommended scales are the numeric rating scale 0-10 and visual analogue scale. However, these scales allow for considerable influence of individual imagination, previous experience, and coping skills, limiting proficiency in comparative clinical trials. We aimed to explore postoperative expressions of "how much it hurts"-the first step to improve pain intensity measurement.

Methods: This was a qualitative study using inductive content analysis: words and visual cues describing pain intensity were collected from (i) existing pain intensity measures by search of COSMIN, PubMed, and Google, (ii) patient interviews recorded and transcribed word-for-word, (iii) clinician interviews transcribed likewise, and (iv) 100 patient telephone interviews with notes taken. After familiarization, the collected expressions were labelled inductively in categories and assembled in tables (case and theme-based matrices).

Results: Descriptors fell into 12 categories: intensity (slight/strong), evaluative (negligible/unbearable), cognitive impact (distracting/can be ignored), activity impact (limits some/all activity), sleep impact (can/cannot sleep), examples (like stubbing a toe), physical signs (crying/writhing), associated symptoms (nauseating/tiring), treatment (ice helps/need morphine), affective (annoying/dreadful), discriminative (aching/piercing), and general recovery (hindering recovery/functional interference). Many visual cues were also identified. Literature and recorded interviews gave rise to the categories, and telephone interviews found saturation, providing no further categories.

Conclusion: Pain intensity is expressed by terms that fall into 12 categories and by a variety of graphic elements. This advances development of a patient-reported outcome measure of pain intensity for orthopedic trials.

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骨科试验中术后急性疼痛强度的测量:定性概念激发研究。
背景和目的:疼痛强度是手术临床试验中的一项重要结果,因为减轻疼痛对患者来说非常重要。目前,推荐的量表是 0-10 级数字评分表和视觉模拟评分表。然而,这些量表在很大程度上受个人想象力、以往经验和应对技能的影响,限制了比较临床试验的熟练程度。我们旨在探索术后对 "有多痛 "的表达方式--这是改进疼痛强度测量的第一步:这是一项采用归纳内容分析法的定性研究:描述疼痛强度的词语和视觉线索来自:(i) 通过搜索 COSMIN、PubMed 和 Google 收集的现有疼痛强度测量方法;(ii) 逐字记录和转录的患者访谈;(iii) 同样转录的临床医生访谈;(iv) 100 个带笔记的患者电话访谈。熟悉情况后,对收集到的表达方式进行归纳分类,并汇总成表格(基于病例和主题的矩阵):结果:描述符分为 12 个类别:强度(轻微/强烈)、评价性(可忽略/无法忍受)、认知影响(分散注意力/可忽略)、活动影响(限制部分/所有活动)、睡眠影响(可以/无法入睡)、实例(如磕破脚趾)、体征(哭泣/啼哭)、相关症状(恶心/疲倦)、治疗(冰敷/需要吗啡)、情感(烦人/可怕)、辨别(疼痛/刺痛)和一般恢复(阻碍恢复/功能干扰)。此外,还发现了许多视觉线索。文献和录音访谈产生了这些类别,而电话访谈已达到饱和,不再提供更多类别:结论:疼痛强度可通过 12 个类别的术语和各种图形元素来表达。这推动了骨科试验中患者报告的疼痛强度结果测量方法的发展。
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来源期刊
Acta Orthopaedica
Acta Orthopaedica 医学-整形外科
CiteScore
6.40
自引率
8.10%
发文量
105
审稿时长
4-8 weeks
期刊介绍: Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
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