[Health-related quality of life in patients with chronic pain].
OBJECTIVE
An empirical comparison of the performance characteristics of 3 generic health-related quality of life (HRQL) measures in pain patients.


METHODS
The Nottingham Health Profile (NHP), the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), and the German Life Satisfaction Scale (FLZ-M) by Henrich et al. were simultaneously employed in a multicenter survey measuring the impact of pain on quality of life. The HRQL- instruments were incorporated into the German Pain Questionnaire (pain variables, CES-D, Pain Disability Index).


RESULTS
Characteristics of 3294 pain patients of 13 pain facilities are detailed in tables 1-3. Six of the 8 SF-36- and 4 of the 6 NHP-scales show satisfactory item-total correlations, bottom- and ceiling-effects, and internal consistency. FLZ-M reliabilities are satisfactory. The item weighting procedure of the FLZ-M proves to be unnecessary. Principle component analyses result in 7 factors for the SF-36 and the NHP. Six of the SF-36-factors are fairly homogeneous. The heterogeneity of the NHP- factors is marked. Correlations of the HRQL scales with depression (CES-D), anxiety (STAI) and physical functioning (FFbH-R-18) are high in all related contents. All instruments discriminate well between headache and back pain patients, between several pain grades (v. Korff) and the 3 Mainz pain chronicity stages.


CONCLUSIONS
The SF-36 has satisfactory to good psychometric properties in pain patients, the NHP item selection has to be improved. The FLZ-M weighting can be eliminated. The shortcomings of the SF-36 can be overcome by adding short scales on role functioning and pain (modular approach).
DRK-Schmerz-Zentrum Mainz, Germany. hugerbershagen@schmerz-zentrum.de
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Gerbershagen
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Lindena
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Korb
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Kramer
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005858:Germany; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology* / Q000523:psychology*; D010147:Pain Measurement; D010865:Pilot Projects; D011788:Quality of Life; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires