Articles: pain-measurement.
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This paper reports two studies of chronic pain patients (n = 444) relevant to the psychometric properties of the Pain Disability Index (PDI), a self-report instrument that has been used to assess the degree to which chronic pain interferes with various daily activities. In the first study, patients with high PDI scores reported more psychological distress (P less than 0.001), more severe pain characteristics (P less than 0.001), and more restriction of activities (P less than 0.001) than patients with low PDI scores, findings supportive of the construct validity of the measure. Further, a multiple regression showed that a linear combination of 9 variables predicted PDI scores (R = 0.74): time spent in bed, psychosomatic symptoms, stopping activities because of pain, work status, pain duration, usual pain intensity, quality of life, pain extent, and education. ⋯ It also showed the PDI to be associated with the levels of pain behavior exhibited by these patients. The findings of both studies generally support the reliability and validity of the PDI as a brief measure of pain-related disability. Questions regarding its test-retest reliability and lack of association with certain pain behaviors are discussed, as are suggestions for future research.
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The present exploratory study measured pain and tactile thresholds in response to mechanical stimulation of the hand before labor, during labor, and after parturition in women. In women who had Lamaze childbirth preparation (but not in women who did not have childbirth preparation), pain thresholds were significantly higher during labor (determined up to 8 cm cervical dilatation) than prior to labor and 24 hours postpartum. ⋯ These findings support earlier findings in this laboratory that vaginocervical mechanostimulation elevated pain thresholds in human and animal subjects, and more recent findings that pain thresholds increased in rats during delivery of individual young. The present findings suggest that an endogenous process that attenuates the pain of parturition is activated when the cervix dilates during labor.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesic efficacy and safety of single-dose oral and intramuscular ketorolac tromethamine for postoperative pain.
The efficacy and safety of the analgesic drug ketorolac tromethamine in the treatment of moderate to very severe postoperative pain was assessed in five dose-ranging studies with single-dose, double-blind, randomized, parallel-group designs. The drug was administered orally (2.5-200 mg, 352 patients in three trials) and intramuscularly (5-90 mg, 395 patients in two trials), and compared with placebo and reference drugs. Patients subjectively evaluated pain intensity and relief using verbal categoric and visual analog scales; efficacy values included pain intensity difference (PID), summed PID, and total pain relief. ⋯ Intramuscular ketorolac 10 and 30 mg were superior to intramuscular meperidine 50 and 100 mg. Ketorolac was well tolerated, with rates of adverse events generally lower than those of the opiate comparators. Ketorolac doses of 2.5 and 5 mg were less effective than higher doses; 10 mg or more resulted in faster onset of action and greater peak efficacy; 90 mg or more gave more prolonged analgesic effects.
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Randomized Controlled Trial Clinical Trial
Determinants of pain assessment by nurses.
In this replication study pain assessment and patient perception by nurses was studied in relation to patient characteristics and nurse characteristics. Nurses were randomly assigned to one of 24 descriptions of a hypothetical patient of constant age and unspecified sex. The 24 descriptions varied by duration of pain, presence of a physical pathology, diagnosis category, and depression symptoms. ⋯ Nursing experience seems also to be important in pain assessment. First-year student nurses attributed less pain to the hypothetical patient than third- and fourth-year student nurses and registered nurses. In addition they perceived the patient as more positive when physical pathology was present or when no symptoms of depression were present.
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The Hospice journal · Jan 1990
Cancer pain intensity measurement: concurrent validity of three tools--finger dynamometer, pain intensity number scale, visual analogue scale.
Although the visual analogue scale (VAS) and number scales are known to be valid and sensitive measures of pain intensity, some older individuals are unable to use them. For individuals who lack the ability to use these scales, valid alternative measures of pain intensity would be useful for research and clinical practice. The purpose of this study was to examine the concurrent validity of a new measure of pain intensity, the Finger Dynamometer (FD), in a sample of 15 adults with advanced stage cancer pain. ⋯ Strong correlation was found between the VAS and the PINS (gamma = .77 to .89; p less than .001). Findings support the concurrent validity of the VAS and the PINS but indicate that further research is necessary to establish the psychometric properties of the FD as a measure of pain intensity in chronic pain models, such as cancer pain. Recommendations are made regarding important variables to be considered in further research with the FD.