| Objective:In 2015,The expert group of IASP and World Health Organization(WHO)classified chronic pain into 7 categories(chronic primary pain,chronic cancerous pain,chronic postoperative pain and traumatic pain,chronic neuropathic pain,chronic headache and orofacial pain,chronic visceral Pain,and chronic musculoskeletal pain,and planed to include this classification in the International Classification of Disease(ICD)version 11 for the first time.This study:(1)Want to provide references for the diagnosis,treatment and prevention of chronic pain,by preliminary epidemiological investigations and population distributive characteristics analysis for the 7 categories' s chronic pain patients who were over 50 and had been diagnosed by clinicians;(2)Then,want to translate the Short-form Mc Gill Pain Questionnaire-2(SF-MPQ-2-CN)into Chinese,and adapt it to Chinese culture;after that,this study want to test its reliability and validity through sampled population.Methods:(1)Combined with the clinical manifestations and past medical history of Chinese chronic pain patients,and some study reports of chronic pain epidemiological investigation in some cities,a questionnaire for chronic pain epidemiological investigation was developed by a group of experts in pain medicine and public health.After obtaining the authorization of the original author and following the Beaton principle,the research team and the School of Social Development and Public Policy of Beijing Normal University jointly performed the translation,back-translation and cultural adaptation of the English version of the SF-MPQ-2 scale.(2)After convenient sampling from the diagnosed patients who were over 50 and from four regions of three provinces,each clinical center established a database with the original surver data by software Epidata3.0,and performed the statistical analysisby using SAS 9.13,SPSS21.0,and AMOS21.0.The general characteristics of chronic pain patients such as gender,age,occupation,and educational level were statistically described,while the proportion of pain severity was compared by using rank sum test and Chi-square trend test.The sampling time was betweent June 2015 and November 2015.(3)The study evaluated the reliability and validity of the SF-MPQ-2-CN,by using correlation analysis,reliability analysis,principal component analysis and confirmatory factor analysis,respectively.Results:(1)According to the classification of chronic pain in ICD-11,the proportion of different categories in the all 1545 cases that were sampled,were as followed:chronic primary pain was 21(1.36%),chronic cancer pain was 32(2.07%),chronic postoperative pain and post-traumatic pain was 26(1.68%),chronic neuropathic pain was 501(32.43%),chronic headache and orofacial pain was 445(28.80%),chronic visceral pain was 176(11.39%),chronic musculoskeletal pain was 344(22.27%).Because of the sample size,the data of chronic neuropathic pain,chronic headand orofacial pain,chronic visceral pain and chronic musculoskeletal pain were analyzed statistically,while the data of the rest three categories were not analyzed further.(2)The constituent ratios of patients with different pain severity in patients with chronic pain were statistically different between different genders(Z=14.65,P<0.0001);The differences of constituent ratios of patients with different pain severity among patients with different work were statistically significant(?2=61.3,P<0.0001);Between the patients smoking and not smoking,constituent ratios of patients with different pain severity were statistically different(Z=-3.93,P<0.0001),and the proportion of patients with severe pain in non-smoking patients was higher than that in smoking patients;The constituent ratios of patients with different pain severity among patients with different education levels was statistically different(?2= 17.72,P<0.01),and the higher the degree of education,the higher the constituent ratio of severe pain patients;There was no statistical difference in the constituent ratio of patients with different pain severity among patients of different ages(?2 = 1.588,P = 0.45);The constituent ratios of patients with different pain severity among patients with different marital status were not statistically different(?2=8.36,P=0.079);There was no statistical difference in the constituent ratio of patients with different pain severity between the patients consuming alcohol and not(Z=0.42,P=0.6736).(3)Assessing chronic visceral pain,according to the classification of chronic pain in ICD-11,the ICC,calculated by the test–retest method,also indicated excellent reliability,with values of 0.909,0.973,0.988,0.952,and 0.927,for the continuous,intermittent,predominantly neuropathic,and affective subscales and the total scale,respectively.Cronbach's alpha for subscales ranged from 0.896 to 0.916,and that of the total scale was 0.836 and 0.831 for primary and secondary visits,respectively.Four components with a variance of 73.55% were extracted that were comparable with the original SF-MPQ-2-CN subscales of continuous,intermittent,neuropathic,and affective.The value of each factor loading was >0.4.When assessing neuropathic pain,the Cronbach's alpha for the four subscales of SF-MPQ-2-CN were 0.357,0.629,0.517,and 0.505,respectively;for chronic headache and maxillofacial pain,the four dimensions of Cronbach's alpha were 0.668,0.527,0.542,and 0.549,respectively;and assessing chronic skeletal muscle pain,Cronbach's alpha coefficients were 0.465,0.656,0.494,and 0.576,respectively.Conclusion:(1)Among the preliminary sampled 1545 patients with chronic pain,which were from four regions of three provinces in China,the study found that patients with neuropathic pain were the most,reaching to 501 cases(32.43%),followed by chronic headache and orofacial pain(445,28.80%),chronic musculoskeletal pain was(344,22.27%),chronic visceral pain(176,11.39%).While the number of other three kinds of chronic pain patient was not enough for statistical analysis,maybe because of diversion of other departments.(2)Using rank sum test and Chi-square trend test,it was found that the constituent ratios of patients with different pain severity were different among patients with different gender,occupation,education level and smoking history.(3)According to the reliability and validity test results of SF-MPQ-2-CN,the Cronbach's alpha coefficient of visceral pain was over 0.8,while the other three categories' were all below 0.8.Therefore,this study considered that the SF-MPQ-2-CN were more suitable for the assessment of chronic visceral pain.It is recommended that specific assessment scales be developed for different categories of chronic pain. |
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