Pain
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The main objective of this research was to determine the initial psychometric properties of the Faces Pain Scale - Revised (FPS-R) as a measure of pain intensity for use with Catalan children and adolescents. Results of the Catalan version of this scale (FPS-R-C) are similar to those obtained with the original instrument. In order to assess the validity and reliability of the FPS-R-C, two different samples were studied. ⋯ Overall, these results provide preliminary evidence of the reliability, and convergent and criterion-related validity of the FPS-R-C. Moreover, all participating subjects were asked to choose the pain scale they preferred the most. Our data suggest that, regardless of their age and/or gender, the subjects prefer the FPS-R-C to the CAS.
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Randomized Controlled Trial Clinical Trial
Effects of exposure on perception of pain expression.
The present study evaluated the effects of exposure to facial expression of pain, on observers' perceptions of pain expression. Thirty-one male and 49 female observers judged 1-s video excerpts in a signal detection paradigm. The excerpts showed facial expressions of shoulder-pain patients displaying no pain or moderate pain. ⋯ There was a linear relationship between the density of exposure to strong pain and observers' response criteria: greater exposure was associated with more conservative decisions. On average, participants showed very high levels of sensitivity to pain expression, with women significantly outperforming men. Results are discussed in terms of their implications for pain judgments of health care professionals, adaptation-level theory, and the psychophysical method of selective adaptation.
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A patient's readiness to adopt a self-management approach to pain has been hypothesized to increase during multidisciplinary pain treatment and to impact pain coping responses. The Pain Stages of Change Questionnaire (PSOCQ; [J Pain (1997) 227]) was designed to assess four components of readiness to self-manage pain: pre-contemplation, contemplation, action, and maintenance. ⋯ The findings supported all three hypotheses. We discuss the implications of the findings for understanding motivational issues in the self-management of pain.
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Pain perception and autonomic responses to pain are known to be altered in dementia, although the mechanisms are poorly understood. We studied patients with Alzheimer's disease (AD) whose cognitive status was assessed through the Mini Mental State Examination test and whose brain electrical activity was measured by means of quantitative electroencephalography. After assessment of both cognitive impairment and brain electrical activity deterioration, these patients underwent sensory measurements in which the minimum stimulus intensity for both stimulus detection and pain sensation was determined. ⋯ These results indicate that pain anticipation and reactivity depend on both the cognitive status and the frequency bands of the electroencephalogram, whereas both stimulus detection and pain threshold are not affected by the progression of AD. These findings indicate that, whereas the sensory-discriminative components of pain are preserved even in advanced stages of AD, the cognitive and affective functions, which are related to both anticipation and autonomic reactivity, are severely affected. This sensory-affective dissociation is well correlated with the neuropathological findings in AD.
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Little is known about the relationship between chronic pain status and overall use of healthcare. We examined whether disabling chronic pain was associated with more frequent use of healthcare in three settings: primary care, emergency departments, and hospital admissions. We used data from Computer-Assisted Telephone Interviews (CATI) of 17,543 residents in New South Wales, Australia aged 16 and over who were randomly sampled using a population-based two-stage stratified sample and random digit dialing methods. ⋯ There was a strong association between pain-related disability and greater use of services. Further work is needed to understand the nature of this association. Given the fluctuating course of chronic pain over time, there is a significant segment of the population that may be at risk of developing higher levels of disability associated with increased use of services.