Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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The McGill Pain Questionnaire, Japanese version, reconsidered: confirming the theoretical structure.
Based on a tripartite theoretical model of pain, the Pain Rating Index (PRI) of the McGill Pain Questionnaire (MPQ) continues to be one of the most frequently used instruments to measure clinical pain. However, language and cultural barriers have hindered its wide use and standardization in Japan. Although a number of exploratory factor analysis studies have failed to support consistently the theoretical structure of the MPQ, a few previous confirmatory factor analysis studies did statistically support the a priori model. ⋯ CFA was completed on the first 16 PRI subclass scores; this process yielded a well fitting final model that explained 92% of the covariance in the observed data. The results supported the hypothesis that the sensory, affective and evaluative subscales of the PRI are representative of the multidimensionality of the pain experience, with minimal overlap. It is suggested that the theoretical structure of the MPQ is maintained in the JMPQ used in this study. Therefore, this study is the first step toward standardization of the JMPQ, serving as a cultural bridge in the field of pain medicine between Japan and English-speaking nations such as Canada.
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To further develop an empirically based classification system for chronic pain patients through the examination of age and sex differences, and incorporation of pain duration in the grouping algorithm. ⋯ There are important age and sex differences in the clinical presentations of chronic pain patients. Some older patients present with unique clinical profiles that may reflect cohort differences, and/or physiological or psychological adjustment processes. There appears to be a greater number of distinct chronic pain presentations among females. Research on the classification of chronic pain patients within homogeneous diagnostic subgroups is needed.
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Clinical Trial Controlled Clinical Trial
Effects of flotation-REST on muscle tension pain.
The purpose of the present study was to investigate whether the floating form of the restricted environmental stimulation technique (REST) may be applied within the field of pain relief. Flotation-REST consists of a procedure whereby an individual is immersed in a tank filled with water of an extremely high salt concentration. Thirty-seven patients (14 men and 23 women) suffering from chronic pain consisting of aching muscles in the neck and back area participated in the study. ⋯ Further, the results indicated that circulating levels of the noradrenaline metabolite 3-methoxy-4-hydroxyphenylethyleneglycol were reduced significantly in the experimental group but not in the control group following treatment, whereas endorphin levels were not affected by flotation. Flotation-REST treatment also elevated the participants' optimism and reduced the degree of anxiety or depression; at nighttime, patients who underwent flotation fell asleep more easily. The present findings describe possible changes, for the better, in patients presenting with chronic pain complaints.
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Pain perception is known to depend on integrated cognitive processing. Alzheimer's disease affects 5% to 10% of older adults, but the impact of this disease on pain sensitivity and report has yet to be fully investigated. ⋯ The present findings indicate that pain perception in response to an acute heat pain stimulus is not diminished in older persons with cognitive impairment. Patients with Alzheimer's disease may be slightly less reliable in threshold pain report, although the subjective rating of evoked pain and the level of poststimulus cortical activation following noxious stimulation were found to be similar to those of controls. A longer latency of the CERP may suggest slower cortical processing of nociceptive input by persons with Alzheimer's disease.
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The administration of sucrose with and without non-nutritive sucking (NNS) has been examined for relieving procedural pain in newborn infants. The calming and pain-relieving effects of sucrose are thought to be mediated by endogenous opioid pathways activated by sweet taste. The orogustatory effects of sucrose have been demonstrated in animal newborns, and in preterm and full term human infants during painful procedures. ⋯ Although there is uncertainty as to whether the effects of sucrose and NNS are synergistic or additive, there is sufficient evidence to support the efficacy of combining the two interventions for procedural pain relief in infants. In this review article, the underlying mechanisms of sucrose and NNS, separately and in combination for relieving procedural pain in preterm and full term infants, are examined. Clinical and research implications are addressed.