Articles: pain-measurement.
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Even though greater than 60% oncology patients experience pain sometime during the course of their illness, management of this pain still remains an enormous clinical problem. Based on this report, it would appear that pain assessment and management would be a key concern in the care of oncology patients. Yet, from previous research, it is clear that a lack of pain assessment documentation exists, which essentially means legally assessment has not been performed. ⋯ Effectiveness was measured by extracting pain assessment documentation from charts. No significant differences in documentation scores were noted across the three groups. Recommendations and nursing implications concerning continuing education strategies and pain assessment documentation are made.
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Heat stimuli, applied to the skin by non-contact radiation pulses emitted by a CO2-laser, activate simultaneously both A-delta (mean conduction velocity 14 m/s) and C-fibres (0.8 m/s), which terminate in the most superficial skin layers. Correspondingly, brief heat stimuli elicit two pain sensations with mean reaction times of about 500 ms and 1400 ms. Similarly, two evoked potential waveforms were observed in the electroencephalogram: the late components N240/P370 and the ultralate components N1050/P1250. ⋯ In cases with hereditary motor and sensory neuropathy type I or with neurosyphilis, ultralate potentials are observed as correlates of delayed pain perception in the affected body areas. The laser evoked cerebral potentials reflected the clinical disorder of pain sensitivity in most cases, whereas somatosensory evoked potentials in response to conventional nerve stimuli failed in objectifying the diagnosis. As such, evoked cerebral potentials in response to laser heat stimuli applied to the hairy skin can be used for an overall examination of the functional integrity of peripheral small fibres, anterolateral tracts and thalamocortical projections.
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Psychophysiological recordings (electrodermal activity, heart rate, respiration rate and frontalis and back muscle tension) were taken in chronic low back pain (CLBP) patients and control subjects during baseline conditions and during the presentation of six acute pressure pain stimuli. No baseline differences in back muscle tension between CLBP patients and controls were found, but CLBP patients did have higher baseline electrodermal activity. During pain stimulation, CLBP patients showed larger skin conductance reactions than controls. ⋯ Contrary to expectation, no differences were found between CLBP patients and controls in physiological habituation after repeating the pain stimulus. Comparison of subjective pain ratings and psychophysiological variables showed that for control subjects arousal and subjective pain were related. For CLBP patients there was no such clear relationship.
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Few methods exist to assess the affective or reactive dimension of chronic pain, and there are psychometric and practical limitations on the methods that do exist. The current paper reports on the development and validation of the Pain Discomfort Scale, a 10-item instrument designed to fill the need for a brief and psychometrically sound measure of pain affect. ⋯ In addition, the results of both correlational and factor analyses of the PDS with other measures support its distinctiveness (from measures of pain intensity) and construct validity (as indicated by its close association with other measures of pain affect). These results support the use of the PDS in situations where a measure of the affective response to chronic pain is needed.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Validation of electronic by conventional pain diaries].
A new type of electronic pain diary was validated in an open, randomized, crossover study. The main target variables were the comparison of the correctly realized pain assessment entries as well as the recording of the number of adverse events. Selected for the study were 20 patients, who were either hospitalized, partially-hospitalized or treated on an out-patient basis, with painful spondylogenic spinal syndrome or osteoarthritis of the trunk-proximal large joints. ⋯ Likewise, the functional impairment of the affected joints as well as the swelling decreased markedly. The advantages of the electronic data recording system, i.e. closely-meshed controls can be carried out, transcriptional errors are minimized, data can be processed on-line, no possibility to subsequently change an entry, stand in contrast to the feature that there is no possibility to make free-style entries. The employment of the electronic system in the recording of individual data and subjective data represents a substantial improvement with regard to the quantity and quality of the data.