Articles: pain-measurement.
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J Pain Symptom Manage · Aug 1995
Randomized Controlled Trial Clinical TrialA revised measure of acute pain in infants.
Acute pain in infants is not assessed or managed optimally. The objectives of the study were (a) to adapt a behavioral pain assessment measure (Children's Hospital of Eastern Ontario Pain Scale, CHEOPS) for use with infants, and (b) to establish the reliability and validity of the measure in a study of infants undergoing immunization. Ninety-six healthy 4- to 6-month-old infants were randomized to receive either the local anesthetic cream Eutectic Mixture of Local Anesthetics (EMLA) (N = 49), or a placebo (N = 47) prior to immunization. ⋯ Agreement between raters' scores was high (intraclass correlation coefficient, 0.95). Results from this study suggest that this measure has beginning construct and concurrent validity and interrater reliability when used in a research study. Further testing of the measure in the clinical setting is required.
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Comparative Study
Comparison of patients' ratings and examination of nurses' responses to pain intensity rating scales.
Patients' ratings of pain intensity are an important component of a comprehensive assessment of pain. Although a 10-cm visual analog scale (VAS) is recommended for quantifying subjective pain intensity, a 0 to 5 point numerical rating scale (NRS) is commonly used. These two scales are often viewed as interchangeable or mathematically equivalent, with a 2 on a 0 to 5 point scale seen as equal to a 4 on a 10-cm VAS. ⋯ Results indicated that patients do not rate their pain in a mathematically equivalent way. VAS ratings were lower than NRS ratings, and more than three quarters of patients provided ratings that were not mathematically equivalent. In addition, nurses provided with fictitious patient scenarios did not provide the same pain medication for equivalent ratings and chose smaller analgesic doses in comparison with experts.
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The McGill Pain Questionnaire (MPQ) (Melzack 1975) is an important assessment tool for multidimensional pain measurement in both clinical practice and research. Despite widespread acceptance, empirical analyses have not consistently verified the 3 a-priori factors that guided the subclass construction of the Pain Rating Index (PRI) of the MPQ. This study compared the a-priori model with 2 qualitatively different factor models in 191 patients with oral mucositis pain at 3 days and 10 days following bone marrow transplantation. ⋯ Although the factor analyses indicated an unambiguous ranking of PRI models according to statistical criteria, these theoretical results generalize poorly to simple scores formed by direct addition of the PRI subclasses. Summary scores can only approximate the unobserved factors and cannot retain the fine discriminations revealed by the theoretical factors. Psychometric considerations suggest that a single PRI total score will yield better practical measurement than any scoring rules based on multiple factors.
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Clinical Trial
Scaling the affective domain of pain: a study of the dimensionality of verbal descriptors.
This study evaluated the multidimensional structure of affective verbal descriptors and investigated individual differences in the scaling of the descriptors. Patients with chronic low back pain, chronic headache and rheumatoid arthritis (25 per group) and 25 control subjects, matched for age and sex, made similarity judgements of a set of 12 verbal descriptors, e.g., awful, miserable. They also completed the Coping Strategies Questionnaire, the Hospital Anxiety and Depression Scale, McGill Pain Questionnaire Short Form, and a measure of verbal intelligence. ⋯ There were significant differences between the groups in their weighting of the dimensions and in their self-reported coping strategies. The results are discussed with reference to an earlier study and the degree of consistency across the studies is noted. Implications of the results for the conceptualisation and measurement of the affective domain of pain report are outlined.
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The aim of this study was to determine if pre-emptive systemic fentanyl administration would decrease the amount of formalin pain in mice. ⋯ Pre-emptive administration of subcutaneous fentanyl does not decrease the severity of acute pain in mice.