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Externe Validität der schmerzbedingten Funktionsbeeinträchtigung

Messen wir, was wir messen wollen?

External validity of pain-linked functional interference

Are we measuring what we want to measure?

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Zusammenfassung

Hintergrund

Die Erfassung schmerzbedingter Funktionseinschränkungen (FE) spielt im Rahmen der frühen postoperativen Rehabilitation eine herausragende Rolle in der Optimierung der postoperativen Schmerztherapie. Ziel der vorliegenden Studie war die Prüfung der externen Validität von 3 FE-Items (Mobilisierung, Respiration, Schlaf) des Quality-Improvement-in-Postoperative-Pain-Management(QUIPS)-Fragebogens im stationären postoperativen Setting.

Material und Methoden

Mit dem QUIPS-Outcomefragebogen wurden 380 Patienten aus der Abdominalchirurgie und Traumachirurgie/Orthopädie befragt. Als externe Validitätskriterien für die Messung der schmerzbedingten FE von Mobilisierung, Respiration und Schlaf dienten die Tolerierung der Gelenkmobilisierung durch eine Motorschiene, die anhand des Peak-Flows gemessene Einschränkung der Lungenfunktion und die mithilfe der Aktigraphie erfasste Schlafqualität.

Ergebnisse

Der QUIPS-Outcomefragebogen erreicht gute Reliabilitätswerte (rtt=0,783–0,954; interne Konsistenz: 0,597–0,941). Die 3 FE-Items erzielten signifikante mittlere Korrelationen (r=0,407–0,469) mit den externen Kriterien.

Schlussfolgerungen

Der QUIPS-Outcomefragebogen erwies sich als reliables Messinstrument für Akutschmerz. Die externe Validität der FE-Items zu Mobilisierung, Respiration und Schlaf für das stationäre postoperative Setting konnte im Rahmen der verwendeten Validitätskriterien belegt werden.

Abstract

Background

Measurement of functional interference (FI) of pain is crucial for postoperative pain management. This study examined the external validity of three FI items (respiration, mobilization and sleep) within the framework of the German quality improvement in postoperative pain management (QUIPS) project.

Material and methods

A total of 380 patients undergoing trauma/orthopedic or abdominal surgery were asked to complete the QUIPS outcome questionnaire. Criteria to determine external validity of FI assessment were tolerance to a continuous passive motion (CPM) machine for FI with mobilization, the pre-postoperative difference of peak flow for FI with respiration and sleep quality measured with actigraphy for FI with sleep.

Results

The QUIPS outcome questionnaire achieved satisfactory reliability (rtt =0 .783-0.954, internal consistency 0.597-0.941). The three FI items under examination achieved a significant correlation (r =0 .407-0.469) with the external criteria.

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  1. Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland

    J. Rothaug, T. Weiss & W. Meissner

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  1. J. Rothaug
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  2. T. Weiss
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  3. W. Meissner
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Correspondence to J. Rothaug.

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Rothaug, J., Weiss, T. & Meissner, W. Externe Validität der schmerzbedingten Funktionsbeeinträchtigung. Schmerz 26, 396–401 (2012). https://doi.org/10.1007/s00482-012-1154-4

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