Articles: pain-measurement.
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The key to effective pain control is accurate assessment and, more importantly, the belief that what patients state about their pain is true. This research study investigates nurses' attitudes to pain and its assessment, and reveals why pain control continues to be an inconsistent affair.
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Atypical facial pain is generally an unclearly defined pain syndrome. We tested in 35 patients (31 women, 4 men) with a mean age of 53.2 +/- 14.9 years and a chronic facial pain syndrome the quality of the new diagnostic criteria of the International Headache Society (IHS), at the same time using the SCL-90-R (Self-Report Symptom Inventory), to identify any associated psychopathology. In accordance with the literature there is a marked female preponderance, an altogether vague description of symptoms and a long history of incorrect diagnoses. ⋯ Depression is by no means the only psychopathological abnormality in atypical facial pain; a broad spectrum of complaints is seen. The IHS classification appears insufficient to separate atypical facial pain from other primary headache and facial pain syndromes. We therefore suggest a modified version of the IHS criteria for atypical facial pain.
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This study evaluates the reliability and validity of the Toddler-Preschooler Postoperative Pain Scale (TPPPS), an observational scale developed to be a clinically useful measure of postoperative pain in children aged 1-5 years. The TPPPS consists of 7 items divided among 3 pain behavior categories: (1) Vocal pain expression; (2) Facial pain expression; and (3) Bodily pain expression. These items were derived from preliminary studies by the authors and from other observational studies of children's pain behavior. ⋯ The TPPPS was found to possess satisfactory internal reliability (Cronbach's alpha = 0.88). Inter-rater reliability was good, with kappas for the pain behavior items ranging from 0.53 to 0.78. Preliminary evidence of the scale's validity is provided by the sensitivity of the scale to analgesic regimen, the convergence between TPPPS scores and nurse and parent ratings of postoperative pain, and the associations found between TPPPS scores and perioperative vital signs.
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This research develops and evaluates a simple method of grading the severity of chronic pain for use in general population surveys and studies of primary care pain patients. Measures of pain intensity, disability, persistence and recency of onset were tested for their ability to grade chronic pain severity in a longitudinal study of primary care back pain (n = 1213), headache (n = 779) and temporomandibular disorder pain (n = 397) patients. A Guttman scale analysis showed that pain intensity and disability measures formed a reliable hierarchical scale. ⋯ Chronic Pain Grade and pain-related functional limitations at 3-year follow-up. Grading chronic pain as a function of pain intensity and pain-related disability may be useful when a brief ordinal measure of global pain severity is required. Pain persistence, measured by days in pain in a fixed time period, provides useful additional information.