Articles: pain-measurement.
-
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.
-
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.
-
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.
-
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.
-
Although adequate assessment of pain and anxiety during burn wound care serves important clinical and scientific goals (e.g., determination of medication dosage and evaluation of treatment effects), few data are actually available. Studies which compare self-reported pain with observational ratings frequently suffer from small sample sizes or questionable data analysis techniques. This paper presents a study in which 126 burn wound dressing changes were independently rated by patient and nurse(s). ⋯ It is argued that it is not useful to discuss the present and earlier studies only in terms of correctness or incorrectness of observational ratings. Recommendations for future studies include the study of pain-related behaviors, coping mechanisms and effects of treatments. Considering the vast differences in prescription regimes among centers, a multicenter trial would be particularly interesting.