Articles: pain-measurement.
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Painful procedures, experienced by many pediatric patients early in their admission, have been identified by parents in our clinical practice as a source of stress. The purpose of this study was to examine parents' perceptions and concerns about their child's acute pain experience. A convenience sample of 71 parents of 62 children was given a questionnaire that focused on the child's pain intensity, the behaviors that indicated the child was in pain, and the parents' preparation for and involvement in the child's pain experience. The majority of parents were asking for more information about and greater participation in procedures that caused their child pain.
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In sickle cell disease, vaso-occlusion in the small blood vessels leads to bone or joint pain which is variable in intensity and duration. An essential first step toward the development of specific treatment guidelines for such painful episodes in children and adolescents is the accurate evaluation of pain. The systematic assessment of vaso-occlusive pain is addressed through two separate studies. ⋯ In the second, data were gathered over the course of hospitalizations for uncomplicated vaso-occlusive episodes in 17 adolescent patients. Results showed that this pain experience can be quantified, that vaso-occlusive pain spans a broad range of intensity levels, and that there are a number of socioemotional factors associated with the pain experience. Further research to systematically assess the psychometric properties of pain assessment instrument is recommended.
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Two separate studies were carried out to determine if three visual analogue scales for various feelings including pain could be marked consistently by patients, without reference to previously completed scales. Sixty patients undergoing extraction of their lower third molars had measurements of acute preoperative anxiety, expected postoperative pain and postoperative perceived pain three times in quick succession. There was no significant difference between the three measurements for any of the feelings. ⋯ Mean scores for anxiety, mood and pain relief were consistent, but mean pain scores were more variable. There was a very close correlation between any two feelings expressed on these visual analogue scales during both the initial and second visits. Litigation or social problems were not associated with increased pain scores.
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The purpose of this study was to describe various dimensions of the pain experiences of intensive care unit (ICU) patients. A purposive, primarily surgical sample of 24 ICU patients from two hospitals was interviewed after transfer from ICU. All but one patient remembered their ICU stay. ⋯ Results of this study clearly indicate that not only pain but its communication and treatment were significant problems for a substantial portion of this ICU sample. Further descriptive and experimental research of pain characteristics and treatment practices for ICU patients is urgently needed. Improvements in nursing practice that result from such research may make a substantial difference in the comfort and well-being of critically ill patients.
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J Pain Symptom Manage · Aug 1990
New method for measuring young children's self-report of fear and pain.
The purposes of this paper are (a) to describe the conceptual development of the Children's Global Rating Scale (CGRS), a technique for measuring young children's self-report of such constructs as pain and fear that was designed to address the methodological limitations of existing techniques, and (b) to report the findings of a study investigating the convergent and predictive validity of the CGRS in a sample of children undergoing an invasive medical procedure. Anticipatory procedural distress in 145 children between the ages of 4 and 8 was assessed in outpatient phlebotomy using three independent rating sources: children, parents, and a trained clinical observer. Phlebotomists' ratings as to whether or not children's distress during the actual procedure extended the time it usually takes to perform the procedure was used as the outcome criterion in a discriminate analysis in determining the degree to which anticipatory ratings would predict actual clinical distress during the medical procedure. Results provide preliminary support for the convergent and predictive validity of the CGRS revealing significant correlations with the other independent measures of children's anticipatory distress and also revealed that the CGRS was one of the significant variables in predicting children who extended and did not extend the medical procedure.