II. Indices of Pain Intensity Derived From Ecological Momentary Assessments and Their Relationships With Patient Functioning: An Individual Patient Data Meta-analysis

JOURNAL OF PAIN

卷:22

Article

Schneider, Stefan¹  Junghaenel, Doerte U.¹  Broderick, Joan E.¹  Ono, Masakatsu¹  May, Marcella¹  Stone, Arthur A.^1,2 

[1] Univ Southern Calif, Dornsife Ctr Self Report Sci, 635 Downey Way, Los Angeles, CA 90089 USA

[2] Univ Southern Calif, Deparment Psychol, Los Angeles, CA 90007 USA

关键词: Pain intensity;    ecological momentary assessment;    pain indices;    intensive longitudinal data;    individual patient data meta-analysis;   

DOI  :  10.1016/j.jpain.2020.10.002

来源: Elsevier

【 摘 要 】

Pain intensity is a complex and dynamic experience. A focus on assessing patients' average pain levels may miss important aspects of pain that impact functioning in daily life. In this second of 3 articles investigating alternative indices of pain intensity derived from Ecologi-cal Momentary Assessments (EMA), we examine the indices' associations with physical and psy-chosocial functioning. EMA data from 10 studies (2,660 patients) were reanalyzed to construct indices of Average Pain, Maximum Pain, Minimum Pain, Pain Variability, Time in High Pain, Time in Low Pain, Pain after Wake-up. Three sets of individual patient data meta-analyses examined 1) the test-retest reliability of the pain indices, 2) their convergent validity in relation to physical functioning, fatigue, depression, mental health, and social functioning, and 3) the incremental validity of alternative indices above Average Pain. Reliabilities approaching or exceeding a level of .7 were observed for all indices, and most correlated significantly with all functioning domains, with small to medium effect sizes. Controlling for Average Pain, Maximum Pain and Pain Variability uniquely predicted all functioning measures, and Time in High Pain predicted physical and social functioning. We suggest that alternative pain indices can provide new perspectives for understanding functioning in chronic pain. Perspective: Alternative summary measures of pain intensity derived from EMA have the potential to help better understand patients' pain experience. Utilizing EMA for the assessment of Maximum Pain, Pain Variability, and Time in High Pain may provide an enhanced window into the relationships between pain and patients' physical and psychosocial functioning. (C) 2020 by United States Association for the Study of Pain, Inc.

【 授权许可】

Free