Pain
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Pain measurement is a prerequisite for individualized pain management and research into pain interventions. There is a need for reliable and valid pain measures for young children with burns. The aim of this study was to investigate whether the pain observation scale for young children (POCIS), the COMFORT behaviour scale (COMFORT-B) and the nurse observational visual analogue scale (VAS obs) are reliable, valid and clinically useful instruments to measure pain in children with burns aged 0-5years. ⋯ Nurses found POCIS easier and quicker to use, but COMFORT-B was found to indicate pain more accurately. Both POCIS and COMFORT-B are reliable, valid and practical scales for pain measurement in young children with burns and can be used in practice and research. The VAS obs was found to be unreliable.
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Primary dysmenorrhea (PDM) is the most prevalent gynecological disorder for women in the reproductive age. PDM patients suffer from lower abdominal pain that starts with the onset of the menstrual flow. Prolonged nociceptive input to the central nervous system can induce functional and structural alterations throughout the nervous system. ⋯ Our results demonstrate that abnormal GM volume changes are present in PDM patients even in the absence of pain. These changes may underpin a combination of impaired pain inhibition, increased pain facilitation and increased affect. Our findings highlight that longer lasting central changes may occur not only in sustained chronic pain conditions but also in cyclic occurring pain conditions.
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Functional ability, including the ability to perform activities of daily living (ADL), is considered a core outcome domain in chronic pain clinical trials and is usually assessed through generic or disease-specific self-report questionnaires. Research, however, indicates that self-report and performance-based assessment of ADL offer distinct but complementary information about ability. The present study, therefore, investigated the applicability of a performance-based measure of ADL ability, the Assessment of Motor and Process Skills (AMPS), among 50 women with chronic widespread pain. ⋯ Data were obtained based on a repeated measures design performing AMPS evaluations twice pre- and twice post-rehabilitation. Results indicated that the ADL motor ability measures of the participants were significantly lower than those of healthy women of same age, the ADL motor and ADL process ability measures remained stable when no intervention was provided and the ADL motor ability measures were sensitive to change following a 2-week interdisciplinary rehabilitation program. A weak correlation (r(s)=-0.35) was found between self-reported ADL ability as measured by the physical function subscale of the Functional Impact Questionnaire (FIQ) and performance-based ADL motor measures, and no correlation (r(s)=-0.02) was found between FIQ ADL measures and ADL process ability, supporting the need for both performance-based and self-reported assessment of ADL.
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For musculoskeletal disorders like low back pain and fibromyalgia, evidence is growing for fear of movement to play an important role in the development of chronic pain. In temporomandibular disorder (TMD) patients, however, this construct has not received any attention yet. Therefore, in this paper, (1) a generally used instrument to measure fear of movement, the Dutch version of the Tampa Scale for Kinesiophobia (TSK), was adapted for its use in TMD patients (and translated for equivalence to English), (2) the psychometric properties of the Dutch version of the TSK-TMD were assessed, and (3) the association of various symptoms of TMD (i.e., pain, joint sounds, and limited jaw movements) with fear of movement was evaluated. ⋯ Multiple regression analysis showed that TMD functional problems (i.e., temporomandibular joint sounds or a stuck/locked feeling) were more strongly associated with fear of movement than with pain. This finding leads to new perspectives regarding the interplay between musculoskeletal complaints, cognition, and avoidance behavior. The results provide a basis for use of the 12-item version for routine assessment of fear of movement in TMD patients, and for future clinical studies, for example, to the role of fear of movement in TMD-treatment success.
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Using latent class analysis (LCA), a previous study on patients attending primary care identified four courses of low back pain (LBP) over the subsequent 6 months. To date, no studies have used longitudinal pain recordings to examine the "natural" course of recurrent and chronic LBP in a population-based sample of individuals. This study examines the course of LBP in the general population and elaborates on the stability and criterion-related validity of the clusters derived. ⋯ Three of the four clusters describing the typical course of pain matched the clusters described previously for patients in primary care. Due to the population-based design, this study achieves, for the first time, a close insight into the "natural" course of chronic and recurrent low back pain, including individuals that did not necessarily visit the general practitioner. The findings will help to understand better the nature of this pain in the general population.