Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2004
Comparative StudyA comparison of five pain assessment scales for nursing home residents with varying degrees of cognitive impairment.
The aim of the study was to compare five different pain assessment scales for use with people with different levels of cognitive impairment who resided in nursing homes. The verbal rating scale, horizontal numeric rating scale, Faces pictorial scale, color analogue scale and mechanical visual analogue scale were presented in random order to 113 residents. Cognitive impairment was assessed using the Mini-Mental State Examination. ⋯ Repeated explanation improved completion rates for all the scales. Consistency between scores on the five scales was good for those with none to moderate cognitive impairment and poor for those severely impaired. This study showed no difference in pain scores according to cognitive status.
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J Pain Symptom Manage · Mar 2004
Clinical TrialEfficacy of transdermal nitroglycerin combined with etodolac for the treatment of chronic post-thoracotomy pain: an open-label prospective clinical trial.
Chronic post-thoracotomy pain (CPP) is associated with surgical intercostal nerve injury. Like other forms of neuropathic pain, there is no ideal treatment. Nitroglycerin (NTG) has been found efficacious in acute pain, but has not been tested for chronic pain with neuropathic characteristics. ⋯ The only side effect was mild headache, which was self-limited to the first few days of NTG administration. We conclude that NTG added to etodolac appears to be effective for the treatment of CPP, with minimal side effects. Further randomized blinded studies are required.
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J Pain Symptom Manage · Mar 2004
Self-discrepancy in chronic low back pain: relation to pain, depression, and psychological distress.
Self-discrepancies occur when patients' evaluations of their actual self differ from their views of who they ideally would like to be (ideal self) or feel they ought to be (ought self), or from patients' perceptions of how significant others wish they could be (ideal-other self) or ought to be (ought-other self). These self-discrepancies may be related to psychological functioning and adjustment to pain. This study sought to: 1) determine the reliability of self-discrepancy assessments in patients; 2) determine whether each of the four types of self-discrepancies (actual self vs. ideal self, actual self vs. ought self, actual self vs. ideal-other self and actual self vs. ought-other self) measure a distinct type of self-discrepancy; and, 3) examine the relationship of self-discrepancies to pain intensity, depression, and psychological distress in 93 chronic low back pain patients. ⋯ Furthermore, data analyses showed that patients who had large ought-other self-discrepancies reported more severe pain and higher levels of psychological distress. Patients who had large ideal self-discrepancies reported higher levels of depression and psychological distress. Taken together, these findings suggest that self-discrepancy can be reliably assessed in patients with persistent pain and demonstrate that self-discrepancies are related in meaningful ways to measures of pain, depression, and psychological distress in chronic low back pain patients.
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J Pain Symptom Manage · Mar 2004
Terminal cancer patients' wishes and influencing factors toward the provision of artificial nutrition and hydration in Taiwan.
Identifying the concerns of terminal cancer patients and respecting their wishes is important in clinical decision-making concerning the provision of artificial nutrition and hydration (ANH). The aim of this study was to discover terminal cancer patients' wishes and determine influencing factors toward the provision of ANH. One hundred and ninety-seven patients with terminal cancer, admitted to a palliative care unit in Taiwan over a two-year period, completed a questionnaire interview, which included demographic characteristics, knowledge and attitudes on ANH, the health locus of control, subjective norms, and the wishes to use ANH. ⋯ In conclusion, Taiwanese patients with terminal cancer have insufficient knowledge about AHN and still believe in the benefits of ANH, especially in avoiding dehydration or starvation. The findings of this study indicate the importance of medical professional training and decision-making in the initial consideration of using ANH. By improving the knowledge about ANH among patients, more appropriate decisions can be achieved.
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J Pain Symptom Manage · Mar 2004
Case ReportsPalliation of malignant bowel obstruction using a percutaneous cecostomy.
Bowel obstruction is a common complication of metastatic gastrointestinal and ovarian cancers, and can cause distressing symptoms. Along with medical options, surgical options should be considered in all patients with bowel obstruction, including percutaneous gastrostomy. We report the case of a patient with metastatic colon cancer with an obstructing recurrence at the primary site who was not eligible for major surgery or percutaneous gastrostomy and was managed with a percutaneous cecostomy for symptom control.