Pain
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Drawings by low back pain patients depicting the severity, type, and location of their pain have been suggested as a brief screening technique for psychological involvement in the pain complaints. A study of 212 back pain patients showed that pain drawings cannot validly be used in this way, since over half of the patients meeting MMPI criteria for psychological involvement in their pain were incorrectly identified as normal on the Pain Drawing test.
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This study investigated the quality and magnitude of sensations evoked by electrical tooth pulp stimulation. Detection threshold (the minimum current intensity that evoked a sensation) and pain threshold were determined for tooth pulp stimuli varying in frequency from 5 to 500 Hz. The effect of frequency and intensity of tooth pulp stimulation on the magnitude of sensations was assessed using visual analog scales and verbal descriptor scales. ⋯ These findings suggest that the non-pain sensations evoked in tooth pulp are mediated by a distinct population of afferents that are not involved in the coding of pain. High frequency stimulation that increased the discharge rate of the lowest threshold pulpal afferents resulted in no summation of non-pain sensation and never produced pain. However, high frequency stimulation evoked greater magnitude sensations at higher stimulus currents, indicating that central summation mechanisms were critical for higher threshold afferents signaling more intense non-pain and pain sensations.
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The incidence of pain in 170 children recovering from surgery was surveyed in two major teaching hospitals along with an analysis of analgesic medication prescribed and administered. Analgesic medication was not ordered for 16% of the patients and narcotic analgesic medication ordered was not given for 39% of the patients. In 29% of the patients, where an order for "narcotic or non-narcotic analgesic medication' was written, the non-narcotic drug was given exclusively. ⋯ Others expressed a dread of "the needle' as a way of administering analgesics and preferred to suffer pain to an injection. We have concluded that there is considerable scope to improve pain management in children after surgery. This improvement must be based on improved education of medical and nursing staff in contemporary clinical pharmacology and on improved communication between staff, parents and patients.
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The study investigates beliefs about control and links it to the depression found in those with chronic pain. These beliefs are interpreted within the new model of learned helplessness which distinguishes personal helplessness from universal helplessness on the basis of attributions. ⋯ Higher beliefs in chance, lack of self-blame and correlations between chance, depression and pain support the presence of universal helplessness in this group. The reporting behaviour of pain patients is discussed in the light of these findings.
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This study attempted to predict postoperative pain from preoperative level of anxiety and the amount of information patients possessed regarding their surgery. Pain was assessed via the McGill Pain Questionnaire (MPQ) and a measure of pain complaints--number of analgesics taken. ⋯ Biographical variables were unrelated to postoperative pain. The results were discussed in terms of State-Trait Anxiety theory, Janis' curvilinear prediction model and a contextual perspective of information imparting.