Articles: patients.
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Pathophysiological models of migraine describe stress as a potential activator of migraine. Clinical observations have shown that stress over prolonged periods leads to migraine, particularly in the relaxation period (e.g. sleep) that follows the stress situations. However, psychophysiological investigations have not been able to prove a direct correlation between stress and the reaction of peripheral and central vascular mechanisms. ⋯ The peripheral resistance was measured by Doppler ultrasonography. The results showed a significant response specificity in migraine patients with respect to peripheral resistance. The results are discussed using a diathesis-stress model of migraine.
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During a semi-structured interview 82 migraine patients were asked biographical and illnessrelated questions. They completed psychological instruments on coping behavior (Stressverarbeitungsfragebogen), self-concept (Frankfurter Selbstkonzeptskalen), attributional style (IE-SV-F), illness behavior, and illness-related attributions (Tübinger Attributions-fragebogen). The theoretical background of this research is a cognitive model of coping with stress and illness. ⋯ Some of the pain behavior strategies could be identified as being focused on illness (guarding behavior, avoidance and social withdrawal, resignation and complaint); only the attempt to relax is regarded as being focused on health. Migraine patients show a preference neither for medical nor psychological causal attributions of their illness but score significantly higher on medical than psychological control attributions. The results have implications for psychological therapy.
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Although adequate assessment of pain and anxiety during burn wound care serves important clinical and scientific goals (e.g., determination of medication dosage and evaluation of treatment effects), few data are actually available. Studies which compare self-reported pain with observational ratings frequently suffer from small sample sizes or questionable data analysis techniques. This paper presents a study in which 126 burn wound dressing changes were independently rated by patient and nurse(s). ⋯ It is argued that it is not useful to discuss the present and earlier studies only in terms of correctness or incorrectness of observational ratings. Recommendations for future studies include the study of pain-related behaviors, coping mechanisms and effects of treatments. Considering the vast differences in prescription regimes among centers, a multicenter trial would be particularly interesting.
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For the present investigation 31 out-patients suffering from chronic pain received a pain diary, that is a booklet in which they recorded their pain level on visual analogue scales and daily activities several times during a day. We used weekly interviews and the patient's records in the diary to evaluate the patient's compliance and the influence of a pain diary on the pain perception and on the physician-patient-interaction. We found that most of the patients were willing and able to use the pain diary. 30 out of 31 patients kept the diary voluntarily for an average period of 4 weeks. 70% of the patients regarded the pain diary as helpful irrespective of whether or not they considered it at the same time as burden. ⋯ Patients from this study reported a better control over their pain and improved conciousness of their own body. As the patient plays an active part the pain diary promotes an equal cooperation between physician and patient. The new information derived from a pain diary enables both patient and physician to alter their point of view.
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In pain clinics, thorough documentation of patient-related data is essential for analysis of patient history, long-term evaluation of diagnostic and therapeutic procedures, and research on the etiology and epidemiology of chronic pain syndromes. With these requirements in mind, we realized a microcomputer documentation system based on a commercial data-base software concept (dBASE). Each patient's data are stored in three different sections: data for identification, basic data (mainly diagnostic findings), and treatment related follow-up data. ⋯ The microcomputer documentation system offers listings for administration as well as effective patient scheduling thanks to a recall system by date of last contact, selected therapeutic procedures and any other item in the medical record. A mail-merge service can be applied, which is particularly useful for follow-up-studies. The documentation system means routine work can be standardized and performed in an economical manner, with the ultimate aim of enhancing the quality of pain therapy.