Articles: pain-measurement.
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Accuracy and errors in judges' attempts to differentiate facial expressions that displayed genuine pain, no pain or were dissimulated (i.e., masked and exaggerated) were examined. Judges were informed that misrepresentations in the facial expressions were present and were asked to rate their confidence in classifying these expressions. Detailed, objective coding of the patients' facial reactions (e.g., brow lowering, mouth opening) were related to judges' decisions. ⋯ Judges consistently used rules of thumb based on specific facial cues when making judgments. Certain cues were effectively discriminative. Systematic training in the use of specific cues or the use of articulated decision rules may be helpful in improving judges' accuracy.
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A convenience sample of 24 more experienced, 20 less experienced, and 20 novice nurses assessed videotaped infants in varying degrees of pain (none, mild, moderate, and severe), as determined by an expert panel. Participants identified all information they used in making an assessment (All cues) and that subset they deemed most important (Key cues). Data were analyzed using a two-level analysis of variance (level of assessed pain and pediatric nursing experience). ⋯ Eleven All cues and 11 Key cues differed between infants in pain and not in pain, suggesting that these cues may be potentially useful as predictors of the presence/absence of pain. Three All cues differed both between pain and no pain as well as between levels of pain, which suggests that participants' awareness of subtle leveling might be used in the discrimination of a wider range of pain levels. Differences in cue utilization among the more experienced, less experienced, and novice participants are discussed.
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Multicenter Study Comparative Study
Lack of correlation between the mean tender point score and self-reported pain in fibromyalgia.
To study the validity and nature of self-assessed symptoms among patients with fibromyalgia syndrome (FMS) and to compare our data with findings reported in the US. To determine whether tender point scores correlate with self-reported pain and other symptoms and to study the influence of disease duration. ⋯ The use of a self-report questionnaire for patients with FMS is feasible and appears to be valid. Tender point scores and self-reported pain represent very different aspects of pain in FMS.
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Randomized Controlled Trial Comparative Study Clinical Trial
Responsiveness of functional status in low back pain: a comparison of different instruments.
This study compares the responsiveness of three instruments of functional status: two disease-specific questionnaires (Oswestry and Roland Disability Questionnaires), and a patient-specific method (severity of the main complaint). We compared changes over time of functional status instruments with pain rated on a visual analog scale. Two strategies for evaluating the responsiveness in terms of sensitivity to change and specificity to change were used: effect size statistics and receiver-operating characteristic method. ⋯ The sensitivity to change of the rating of Oswestry Questionnaire was lower than that of the other instruments. The main complaint was not very specific to change. The two strategies for evaluating the responsiveness were very useful and appeared to complement each other.