Articles: chronic-pain.
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Journal of anesthesia · Jun 1997
Simple pain relief score by observers (PRSO) for assessing chronic pain.
In 56 patients with severe chronic pain, pain relief was evaluated by observation of changes in activities of daily life (ADL), drug intake, and patients' mood. The degree of pain relief was scored on the basis of these evaluations by a pain clinic physician, a nurse, and a member of the patient's family. The resulting score was termed "pain relief score by observers" (PRSO). ⋯ Although a significant correlation (rS=0.755,P<0.001) was demonstrated between the mean PRSO and VAS values, there was some dissociation between the two values in patients with underlying personal problems such as compensation lawsuits or job loss. The results suggest that an objective evaluation of pain relief is possible by PRSO alone without subjective assessment, and that PRSO can be used for patients with various types of pain. Combined assessment of pain relief by the VAS and PRSO methods may be useful to detect the influence of personal background factors in patients with chronic pain.
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The present paper is one in a series of publications reviewing German instruments for the psychological assessment of pain. Part X deals with pain measurement of acute and chronic pain in infants and children. German assessment instruments of pediatric pain together with frequently used instruments of American origin are examined and described. ⋯ Multidimensional pain interviews for both children and parents, diaries and rating scales, as well as observation measures especially for infants, are examined. Since the selection of pain-assessment instruments is dependent on the age and cognitive level of the children, for each instrument a minimum age limit is given. In cases in which quantitative indices of reliability, validity and objectivity are still needed, the evaluation is based on qualitative quotations.
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There are only few publications about the effect of music therapy on pain relief. The intention of this prospective study is to demonstrate the influence of the Nordoff/Robbins method of active music therapy in a group of 12 patients with fibromyalgia, myofascial pain syndromes and polyarthritis on pain reduction, life quality and coping. The clinical parameters of each patient were related to the observations in the audio- and video-documented music therapy settings and to the self-reported changes in pain intensity and pain behaviour. ⋯ Active music therapy affects especially the communicative and emotional dimension of chronic pain. Psychophysiological and psychodynamic models are presented to explain the effectiveness of music therapy on pain reduction. Clinical studies on music therapy as well as on other "art therapies" should relate the analysis of clinical parameters to the descriptive-phenomenological documentation of the therapeutic process to demonstrate systematically the influence of music and art in the individual case.
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Studies using a multimodal approach in order to prognose therapeutic success in patients suffering from back pain were seen to have highly diverse results. However, in spite of various independent health care systems, a common interest prevails in identifying determinants of therapeutic success in order to improve therapy. ⋯ Predicting successful treatment is hardly possible without analyzing individual circumstances, focusing on sociodemographic variables, workplace-related conditions, and aspects of individual motivation. With regard to objective therapeutic success, subjective perceptions proved highly influential. Treatment proved successful only when the patient's perception of functional disability was minimized. Hence, individual perceptions and experiences were more important than physical capabilities.
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Acupuncture is being increasingly used as one of the most important non-pharmacological therapies in treatment of chronic pain. Chronic headache, especially migraine and tension headache are diseases frequently encountered. In their treatment acupuncture is a method with very few side effects and is a remarkable alternative or addition in the whole concept of treatment. ⋯ The concept of treatment depends on the basic rules of traditional Chinese medicine (TCM). Selection of the acupuncture points is primarily determined by the pain site. Long-term success could be confirmed by follow-up examinations six to eighteen months after end of the therapy.