Abstract：
Clinicians often ask people with chronic pain about their perceived benefit from interventions designed to improve their pain. The aim of this study is to identify factors that contribute to underestimating or overestimating perceived changes in daily pain intensity over a month of daily assessments. We examined data from individuals with chronic pain who provided at least 28 daily assessments using a pain app as secondary analyses. Participants provided baseline demographic information and completed questionnaires assessing pain, activity interference, mood, pain disability, and catastrophizing. Using the pain app, they entered daily ratings of pain (0 = none, 10 = worst pain possible) and impressions of perceived day-to-day change (0 = better, 5 = same, and 10 = worse). Two hundred fifty-two (N = 252) subjects with chronic pain met the inclusion criteria of completing at least 28 daily assessments. Those who underestimated their improvement tended to have higher pain intensity at baseline (P < .001), reported greater activity interference and disability (P < .001), and were prone to greater catastrophizing and anxiety and depression (P < .01). People who were more accurate in assessing their improvement engaged less with the app with fewer 2-way messages compared with those who either underestimated or overestimated their improvement and who had more 2-way messaging (P < .05). This longitudinal study suggests that those who report greater levels of catastrophizing and anxiety and depression are more likely to underestimate any improvements in their pain over time but seem to engage more with a pain app. Future research will help in our understanding of what magnitude of perceived change in pain ratings is clinically meaningful. PERSPECTIVE: Those who report greater levels of pain, disability, anxiety, depression, and catastrophizing are most prone to underestimate improvements of their pain over time.
摘要：
临床医生经常询问慢性疼痛患者从旨在改善疼痛的干预措施中获得的益处。这项研究的目的是确定在一个月的日常评估中，导致低估或高估日常疼痛强度的感知变化的因素。我们检查了来自慢性疼痛患者的数据，这些患者使用疼痛应用程序作为次要分析提供了至少28项每日评估。参与者提供了基线人口统计信息，并填写了评估疼痛的问卷，活动干扰,心情,疼痛残疾，和灾难。使用疼痛应用程序，他们输入了每日疼痛评分(0=无;10=最严重的疼痛可能)和对日常变化的印象(0=更好;5=相同;10=更差)。患有慢性疼痛的两百五十二(N=252)个受试者符合完成至少28个每日评估的纳入标准。那些低估了他们的改善倾向于有更高的疼痛强度在基线（p<0.001），报告更大的活动干扰和残疾p<0.001），并且容易发生更大的灾难，焦虑和抑郁（p<0.01）。与那些低估或高估他们的改进和双向消息传递更多的人相比，那些更准确地评估他们的改进的人参与更少的双向消息（p<0.05）。这项纵向研究表明，那些报告更高水平的灾难、焦虑和抑郁的人更有可能低估他们的疼痛随着时间的推移而得到的任何改善，但似乎更多地参与疼痛应用程序。未来的研究将有助于我们理解疼痛等级的感知变化幅度在临床上有意义。透视：那些报告疼痛程度更大的人，残疾,焦虑,抑郁症,和灾难是最容易低估改善他们的痛苦随着时间的推移。
