Articles: pain-measurement.
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Review Case Reports
[Use of psychological diagnostic methods in cases of chronic pain].
Problems of patient-physician communication relating to the understanding of verbalized pain sensations are discussed. The author reviews psychological techniques which may be applied for the assessment of pain by the attending physician and facilitate its management. ⋯ Melzack's MPQ and pain-drawing. Pain-drawing technique is illustrated with two comparative cases of patients with chronic backache.
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The Dallas Pain Questionnaire (DPQ) was developed to assess the amount of chronic spinal pain that affects four aspects (daily and work-leisure activities, anxiety-depression, and social interest) of the patients' lives. Results of the DPQ's statistical properties suggest that the DPQ is an externally reliable instrument as well as internally consistent. Two factors emerged from factor structure analysis. ⋯ A t test demonstrated that chronic pain patients have significantly higher DPQ scores than normals. Because these findings support its statistical properties, the DPQ appears to have utility for clinical and research purposes. The findings, limitations, and implications of this study are detailed, as are suggestions for future research.
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Human pain responsivity was defined as the subject's behavioral pain endurance time (PET) to the 1 +/- 0.3 degrees C cold-pressor test, a naturalistic and clinical analogue tonic pain model. Over the past 2 years, we have consistently observed a behavioral dichotomy of pain responsivity in each of our 6 studies (all at P less than 0.000001 effect level), totaling 205 subjects. Overall, the pain-tolerant (PT) subjects could endure the whole 5 min (note that 3 min was the ceiling criterion in the last study) of cold-pressor test, while the pain-sensitive (PS) subjects could merely tolerate the test for an overall mean of 60 sec, 20% of PET in the PT group. ⋯ The psychological/physiological etiology of such drastic human pain responsivity requires intense systematic investigations. This report discusses the results in: (a) individual differences in pain responsivity, (b) characterization of the cold-pressor test as a model for tonic pain, (c) contrast between PS and PT groups of pain perception and state anxiety, and (d) psychological determinants of measures for cognitive, perceptual and affective domains. Discussion was also focused on the experimental tonic pain model and its generality for clinical pain, as well as the basic model of the cold-pressor test for human tonic pain responsivity.
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Comparative Study
The clinical assessment of chronic pain in rheumatic disease: evaluating the use of two instruments.
Health care professionals are becoming increasingly aware of the complex nature of chronic pain. Measurement instruments are needed which will assist in better understanding the patient's response to the pain. The McGill Pain Questionnaire (MPQ) and an expanded version useful in comprehensive clinical assessment, the McGill Comprehensive Pain Questionnaire (MCPQ), are currently-available tools for assessing chronic pain. ⋯ The information gained through the use of the MCPQ was helpful in determining what living with chronic pain means to the individual. Such information should be useful in the future development of a valid and reliable instrument for more efficiently measuring the chronic pain experience. Such an instrument would be useful in coordination with the MPQ which focuses on pain description.
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Comparative Study
The dimensions of pain: a multidimensional scaling comparison of cancer patients and healthy volunteers.
This paper presents a new approach to the measurement and understanding of clinical pain. A multidimensional scaling (MDS) procedure was used to analyze pairwise similarity judgments made to 9 pain descriptors by 24 cancer pain patients and 24 healthy volunteers. The question was whether the dimensions of the global pain space differed between the 2 groups. ⋯ The subject weight space revealed that the Pain Intensity dimension was the most important dimension for the patients, while Emotional Quality was more salient for the volunteers. Wide differences were found in the salience of the various dimensions to different individuals; this information may prove useful for tailoring patient treatment. The study demonstrates that MDS procedures such as INDSCAL, in which the subjects (rather than the researcher) determine the number and characteristics of the global pain dimensions, will improve our understanding and treatment of pain.