Articles: pain-measurement.
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Even though greater than 60% oncology patients experience pain sometime during the course of their illness, management of this pain still remains an enormous clinical problem. Based on this report, it would appear that pain assessment and management would be a key concern in the care of oncology patients. Yet, from previous research, it is clear that a lack of pain assessment documentation exists, which essentially means legally assessment has not been performed. ⋯ Effectiveness was measured by extracting pain assessment documentation from charts. No significant differences in documentation scores were noted across the three groups. Recommendations and nursing implications concerning continuing education strategies and pain assessment documentation are made.
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
Analgesic effects of different pulse patterns of transcutaneous electrical nerve stimulation on cold-induced pain in normal subjects.
The analgesic efficacy of various pulse patterns of transcutaneous electrical nerve stimulation (TENS) were assessed in 84 normal healthy subjects using the cold pressor pain technique. Burst, modulation, random and continuous TENS all significantly elevated ice pain threshold. ⋯ Increasing the size of electrodes reduced the effect of continuous TENS. The clinical implications of these findings are discussed.
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Heat stimuli, applied to the skin by non-contact radiation pulses emitted by a CO2-laser, activate simultaneously both A-delta (mean conduction velocity 14 m/s) and C-fibres (0.8 m/s), which terminate in the most superficial skin layers. Correspondingly, brief heat stimuli elicit two pain sensations with mean reaction times of about 500 ms and 1400 ms. Similarly, two evoked potential waveforms were observed in the electroencephalogram: the late components N240/P370 and the ultralate components N1050/P1250. ⋯ In cases with hereditary motor and sensory neuropathy type I or with neurosyphilis, ultralate potentials are observed as correlates of delayed pain perception in the affected body areas. The laser evoked cerebral potentials reflected the clinical disorder of pain sensitivity in most cases, whereas somatosensory evoked potentials in response to conventional nerve stimuli failed in objectifying the diagnosis. As such, evoked cerebral potentials in response to laser heat stimuli applied to the hairy skin can be used for an overall examination of the functional integrity of peripheral small fibres, anterolateral tracts and thalamocortical projections.
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Few methods exist to assess the affective or reactive dimension of chronic pain, and there are psychometric and practical limitations on the methods that do exist. The current paper reports on the development and validation of the Pain Discomfort Scale, a 10-item instrument designed to fill the need for a brief and psychometrically sound measure of pain affect. ⋯ In addition, the results of both correlational and factor analyses of the PDS with other measures support its distinctiveness (from measures of pain intensity) and construct validity (as indicated by its close association with other measures of pain affect). These results support the use of the PDS in situations where a measure of the affective response to chronic pain is needed.
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Psychophysiological recordings (electrodermal activity, heart rate, respiration rate and frontalis and back muscle tension) were taken in chronic low back pain (CLBP) patients and control subjects during baseline conditions and during the presentation of six acute pressure pain stimuli. No baseline differences in back muscle tension between CLBP patients and controls were found, but CLBP patients did have higher baseline electrodermal activity. During pain stimulation, CLBP patients showed larger skin conductance reactions than controls. ⋯ Contrary to expectation, no differences were found between CLBP patients and controls in physiological habituation after repeating the pain stimulus. Comparison of subjective pain ratings and psychophysiological variables showed that for control subjects arousal and subjective pain were related. For CLBP patients there was no such clear relationship.