PDF(Pubmed)
Abstract：
OBJECTIVE: The relationship between pain and poor healing is intricate, potentially mediated by psychological stress and aberrations in inflammatory response. The purpose of this study was to examine the biopsychosocial model of pain by assessing the relationships between pain, stress, inflammation and healing in people with chronic wounds.
METHODS: This was a 4-week prospective observational study to explore the relationship of pain, stress, inflammation and wound healing in a convenience sample of patients with chronic wounds in a chronic care hospital in Canada.
METHODS: Only subjects over 18 with chronic wounds were recruited into the study. Chronic wounds were defined by the duration of wounds for more than 4 weeks of various aetiologies including wounds caused by pressure injuries, venous disease, arterial insufficiency, surgery or trauma and diabetic neuropathy. Participants were evaluated for pain by responding to the Brief Pain Inventory-Short Form, the McGill Pain Questionnaire-Short Form and the Leeds Assessment of Neuropathic Symptoms and Signs scale. Stress was measured by the Perceived Stress Scale (PSS). All wounds were assessed with the Pressure Ulcer Scale for Healing tool. The levels of matrix metalloproteinases were analysis by obtaining wound fluid from all participants.
RESULTS: A total of 32 individuals with chronic wounds participated in the study. Correlation analysis indicated pain severity was positively and significantly related to pain interference, McGill Pain Questionnaire scores, neuropathic pain and matrix metalloproteinase levels. Logistic regression was used to determine the predictors for high or low perceived stress. The only significant variable that contributed to the stress levels was BPI-I. Results suggested that participants who experienced higher levels of pain interference also had an increased odds to report high level of stress by 1.6 times controlling for all other factor in the model.
CONCLUSIONS: Pain is a complex biopsychosocial phenomenon affecting quality of life in people with chronic wounds. Results of this study identified a significant relationship between pain, stress and wound healing.
METHODS: This was a 4-week prospective observational study to explore the relationship of pain, stress, inflammation and wound healing in a convenience sample of patients with chronic wounds in a chronic care hospital in Canada.
METHODS: Only subjects over 18 with chronic wounds were recruited into the study. Chronic wounds were defined by the duration of wounds for more than 4 weeks of various aetiologies including wounds caused by pressure injuries, venous disease, arterial insufficiency, surgery or trauma and diabetic neuropathy. Participants were evaluated for pain by responding to the Brief Pain Inventory-Short Form, the McGill Pain Questionnaire-Short Form and the Leeds Assessment of Neuropathic Symptoms and Signs scale. Stress was measured by the Perceived Stress Scale (PSS). All wounds were assessed with the Pressure Ulcer Scale for Healing tool. The levels of matrix metalloproteinases were analysis by obtaining wound fluid from all participants.
RESULTS: A total of 32 individuals with chronic wounds participated in the study. Correlation analysis indicated pain severity was positively and significantly related to pain interference, McGill Pain Questionnaire scores, neuropathic pain and matrix metalloproteinase levels. Logistic regression was used to determine the predictors for high or low perceived stress. The only significant variable that contributed to the stress levels was BPI-I. Results suggested that participants who experienced higher levels of pain interference also had an increased odds to report high level of stress by 1.6 times controlling for all other factor in the model.
CONCLUSIONS: Pain is a complex biopsychosocial phenomenon affecting quality of life in people with chronic wounds. Results of this study identified a significant relationship between pain, stress and wound healing.
摘要：
目的：疼痛和愈合不良之间的关系错综复杂，潜在介导的心理压力和异常的炎症反应。这项研究的目的是通过评估疼痛之间的关系来检查疼痛的生物心理社会模型。压力，慢性伤口患者的炎症和愈合。
方法：这是一项为期4周的前瞻性观察研究，旨在探讨疼痛与疼痛的关系。压力，在加拿大一家慢性护理医院的慢性伤口患者的便利样本中，炎症和伤口愈合。
方法：仅招募18岁以上有慢性创伤的受试者参与研究。慢性伤口定义为伤口持续时间超过4周的各种病因，包括由压力损伤引起的伤口。静脉疾病,动脉供血不足,手术或创伤和糖尿病性神经病变。通过对简短疼痛清单简短表格的反应来评估参与者的疼痛，麦吉尔疼痛问卷简表和利兹神经病变症状和体征评估量表。通过感知压力量表(PSS)测量压力。用压力性溃疡治疗工具评估所有伤口。通过从所有参与者获得伤口液来分析基质金属蛋白酶的水平。
结果：共有32名患有慢性伤口的个体参与了研究。相关性分析显示疼痛严重程度与疼痛干扰呈正相关,麦吉尔疼痛问卷得分，神经性疼痛和基质金属蛋白酶水平。Logistic回归用于确定高或低感知压力的预测因子。造成压力水平的唯一重要变量是BPI-I。结果表明，经历较高水平疼痛干扰的参与者在控制模型中所有其他因素时，报告高水平压力的可能性也增加了1.6倍。
结论：疼痛是一种复杂的生物心理社会现象，影响慢性创伤患者的生活质量。这项研究的结果确定了疼痛之间的显着关系，压力和伤口愈合。
方法：这是一项为期4周的前瞻性观察研究，旨在探讨疼痛与疼痛的关系。压力，在加拿大一家慢性护理医院的慢性伤口患者的便利样本中，炎症和伤口愈合。
方法：仅招募18岁以上有慢性创伤的受试者参与研究。慢性伤口定义为伤口持续时间超过4周的各种病因，包括由压力损伤引起的伤口。静脉疾病,动脉供血不足,手术或创伤和糖尿病性神经病变。通过对简短疼痛清单简短表格的反应来评估参与者的疼痛，麦吉尔疼痛问卷简表和利兹神经病变症状和体征评估量表。通过感知压力量表(PSS)测量压力。用压力性溃疡治疗工具评估所有伤口。通过从所有参与者获得伤口液来分析基质金属蛋白酶的水平。
结果：共有32名患有慢性伤口的个体参与了研究。相关性分析显示疼痛严重程度与疼痛干扰呈正相关,麦吉尔疼痛问卷得分，神经性疼痛和基质金属蛋白酶水平。Logistic回归用于确定高或低感知压力的预测因子。造成压力水平的唯一重要变量是BPI-I。结果表明，经历较高水平疼痛干扰的参与者在控制模型中所有其他因素时，报告高水平压力的可能性也增加了1.6倍。
结论：疼痛是一种复杂的生物心理社会现象，影响慢性创伤患者的生活质量。这项研究的结果确定了疼痛之间的显着关系，压力和伤口愈合。
