Articles: pain-measurement.
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Social science & medicine · Jan 1990
Are physicians' ratings of pain affected by patients' physical attractiveness?
The degree to which physical attractiveness and nonverbal expressions of pain influence physicians' perceptions of pain was investigated. Photographs of eight female university students were represented in four experimental conditions created by the manipulation of cosmetics, hairstyles, and facial expressions: (a) attractive-no pain, (b) attractive-pain, (c) unattractive-no pain, and (d) unattractive-pain. Each photograph was accompanied by a brief description of the patient's pain problem that was standard across conditions. ⋯ Unattractive patients, and patients who were expressing pain, were perceived as experiencing more pain, distress, and negative affective experiences than attractive patients and patients who were not expressing pain. Unattractive patients also received higher ratings of solicitude on the doctor's part and lower ratings of health than attractive patients. Physician's assessments of pain appear to be influenced by the physical attractiveness of the patient.
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This study dealt with the validity and correlates of facial expressions of pain. Twenty-four patients seeking treatment for gleno-humeral joint pain and 12 controls underwent a standardized physiotherapy assessment protocol involving active and passive arm movements, and experimental pain induced by pressure. Subjects rated pain intensity on each trial using categorical, sensory and affective scales. ⋯ Greater physical disability was associated with more intense pain actions on active, but not passive, tests. The results support the validity and generality of facial measures of pain, show that they yield graded sensitive information and suggest that they encode information about the psychosocial context of pain problems. Theoretical implications of these findings are discussed.
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Much recent attention has focused on the development and refinement of pain measures, as well as on the use of more effective pain control methods for infants, children, and adolescents. This article reviews the primary categories of pediatric pain measures, with a specific focus on the selection of the most appropriate behavioral, physiologic, or subjective method for assessing a child's pain. The optimum pain measure depends on the age and cognitive level of a child, the type of pain experienced, and the situation in which the pain occurs. While no single measure is adequate for all children for all types of acute, recurrent, and chronic pain, it is possible to choose practical, valid, and reliable methods for evaluating any child's pain experience.
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An observation method for assessing chronic pain in back pain and rheumatoid arthritis has been developed during the last decade in the U. S. A. ⋯ Correlations between pain behavior and other measures of pain, e.g., intensity ratings, medication intake, and spinal mobility, were statistically significant but somewhat lower than expected. The results indicate that the behavioral observation method provides reliable and valid information about non-chronic back pain among Swedish females. However, some modifications in the standardized sequence of maneuvers and the definitions of pain behaviors may be necessary to improve the utility of the method in this population.
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Work and injury related musculoskeletal pain is often complicated by psychological and medicolegal factors that obscure the validity of the pain presentation. Pressure algometry and stretching during thiopentone sodium (Pentothal) anesthesia was studied in 45 cases of musculoskeletal injury. ⋯ In unilateral pain cases, a right to left pressure threshold difference of 2.0 kg/cm2 predicted 94% of true organic pain cases and 100% of cases at a pressure threshold of 1.5 kg/cm2 if combined with stretching. Results of stretching painful areas correlated highly with pressure threshold assessments.