Pain
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Some children and adolescents with sickle cell disease experience frequent painful episodes. To gain information about the natural history of the pain and its impact on sleep and school attendance, we developed a home-based diary system. Eighteen children and adolescents completed 4756 diary days, with an average compliance of 75%. ⋯ Of the pain-associated absenteeisms, two-thirds occurred when pain was managed at home, and one-third when patients were hospitalized. The average consecutive number of school days missed was 2.7. These findings have implications for developmentally critical activities.
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Postmastectomy pain (PMP), a distinctive postsurgical neuropathic pain syndrome, has been thought to be consequence of 4-6% of surgical procedures for cancer of the breast, but remains understudied and poorly documented. In this cross-sectional descriptive study, a convenience sample of 95 women who had undergone breast cancer surgery was recruited from 16 ambulatory care sites. Prevalence, characteristics, and impact of the PMP syndrome were investigated using a medical record review, a patient information questionnaire, a cancer pain questionnaire and the McGill Pain Questionnaire. ⋯ Women experiencing the syndrome reported chronic, stable pain of long duration that began shortly after surgery. They described paroxysms of lancinating pain against a background of burning, aching, tight constriction in the axilla, medial upper arm, and/or chest that significantly interfered with the performance of daily occupational and domestic activities. Data suggest that these women were undertreated and generally obtained poor pain relief from their symptoms.
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This study sought to identify distinct subgroups of chronic pain patients based on responses to the Symptom Checklist 90-revised (SCL-90R), a measure of psychological distress. Two scoring methods were used: the standard scoring that accompanies the manual, and a scoring method based upon factor scores obtained in an earlier study using low back pain patients. Two separate cluster analyses assigned patients into 2 groups: one based on standard scores and one based on factor scores. ⋯ Depending upon group membership, patients significantly differed on measures of qualitative pain and quantitative pain report, depressive symptoms, medication usage, and pain-related behaviors. This study supports the use of SCL-90R factor scoring with pain patients as greater differentiation between clusters was found for pain report and pain-related behavior when this method was used. Guidelines for clinical application of SCL-90R cluster groups is provided.