Articles: pain-measurement.
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Every day patients arrive at Accident and Emergency (A & E) departments in pain due to a multitude of causes. As nurses working in this area, we routinely assess patients both objectively and subjectively, and this includes the intensity and descriptions of their pain and their responses to it. Anxiety and pain are closely linked and it has been shown that the use of pain assessment tools can promote nurse-patient communication, thus reducing anxiety levels, improving pain control and assisting in nursing care. This article explores the use of objective assessment of pain within the A & E setting and discusses the issues surrounding pain assessment as a whole.
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Pain has been difficult to assess because of its multidimensional nature. The primary purpose of this study was to investigate the relationship between the nurse's assessment of behavioral cues to pain and self-reports of pain made by patients using patient controlled analgesia (PCA). This descriptive-correlational study used the PACU Behavioral Pain Rating Scale (BPRS), patient's self-report, and hospital's PCA pain-rating scale to investigate pain measurement. ⋯ Significant relationships (rs = 0.56 to 0.80; P < 0.05) were found between the BPRS scores and the self-reports of pain. The relationship between the hospital's PCA pain rating scores and self-reported pain was significant only during the second assessment (rs = 0.45; P < 0.05). The BPRS consistently showed a moderate to high relationship with the patient's self-report of pain and had a stronger relationship with the patient's self-reported pain than with the hospital's pain scale.
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To determine whether physician estimates of pain severity are influenced by patient ethnicity. ⋯ Physician ability to assess pain severity does not differ for Hispanic and non-Hispanic white patients. Other explanations for a difference in analgesic practice as a function of ethnicity should be explored.
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We investigated pain experienced during burn wound debridement. Forty-nine adult patients with burns and 27 nurses submitted 123 pairs of visual analog scale pain ratings for burn wound debridements. While patients' overall visual analog scale pain scores were found to be evenly distributed, worst pain scores yielded a bimodal distribution with groups centered around means of 2.0 (low pain group) and 7.0 (high pain group). ⋯ According to one researcher's criteria, 53% of nurse pain ratings were accurate. Accuracy of nurses' ratings was unrelated to nursing experience or educational level. Future strategies are presented for comparing high and low pain groups and increasing nurse pain rating accuracy.
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The analgesic effect of acupuncture in chronic gonarthrosis pain was studied in a placebocontrolled trial completed by 97 patients. Each patient was treated twice a week, receiving 10 acupuncture treatments in all. Before and after tee course of treatment all patients were examined by an unbiased independent examiner and the overall pain score was measured over 10 days using VAS scales; functional parameters (resilience) were measured with a modified Lysholm questionnaire. ⋯ After ten treatments the overall reduction in pain score was 47.5% in the verum group (follow-up 48.2%), and 26.1% in the placebo group (follow-up 26.1%). The results are statistically significant (P<0.05); they show that in gonarthrosis pain the analgesic effect of verum acupuncture exceeds that of placebo acupuncture. Measurement of the functional parameters according to the Lysholm score showed no significant change.