Articles: pain-measurement.
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J Dev Behav Pediatr · Jun 1990
The consistency of young children's assessment of remembered painful events.
Clinicians need to know the consistency of a child's report of his pain in order to assess the intensity of that pain. To explore an age cutoff above which children are consistent in reporting their pain, we tested the consistency of children's reports of recalled pain, using a variety of scales. ⋯ However, no age group tested was consistent more than 80% of the time on all measures. We conclude that children are able to report remembered pain intensity consistently with increasing age but that we cannot establish a firm cutoff between the ages of three and eight years with our data.
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Journal of neurosurgery · Jun 1990
Normal and radiculopathic cutaneous pain tolerance levels evaluated by heat-beam dolorimetry.
The heat-beam dolorimeter has previously been used to obtain cutaneous pain tolerance measures in normal volunteers and patients with chronic pain. In the present study, normal reference data were collected at two stimulus intensities for 24 volunteers, and the stimulus-effect relationship (decreasing tolerance latency with increasing stimulus intensity) was found significant (p less than 0.001) for all body sites tested. No overall sex differences were found; males behaved slightly more stoically than females, with differences significant only at the T3 site over the breasts. ⋯ No significant lateral asymmetry was found in cutaneous pain tolerance except at the dorsum of the hand: the right hand evinced elevated pain tolerance compared with the left hand in both right- and left-handed subjects. Eight radiculopathic pain patients with clinically involved left L5 nerve roots were evaluated and their responses were compared with the volunteer normal reference data. The radiculopathic group evinced elevated tolerance levels in both the radiculopathic dermatome and noninvolved sites compared with normal individuals (p less than 0.05).
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Altogether 553 children (195 first graders, mean age 6.8 years, and 358 third graders, mean age 8.7 years) participated in the development of a self-report measure to assess the intensity of children's pain. The first step was the derivation, from children's drawings of facial expressions of pain, of 5 sets of 7 schematic faces depicting changes in severity of expressed pain from no pain to the most pain possible. With the set of faces that achieved the highest agreement in pain ordering, additional studies were conducted to determine whether the set had the properties of a scale. ⋯ The final study checked, with 6-year-old children, the test-retest reliability of ratings for recalled experiences of pain. Overall, the faces pain scale incorporates conventions used by children, has achieved strong agreement in the rank ordering of pain, has indications that the intervals are close to equal, and is treated by children as a scale. The test-retest data suggest that it may prove to be a reliable index over time of self-reported pain.
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Comparative Study
Rheumatoid arthritis: determination of pain characteristics and comparison of RAI and VAS in its measurement.
The purposes of this study were to determine pain characteristics in female patients with rheumatoid arthritis (RA) and to determine the relationship between the outcome of the Ritchie Articular Index (RAI) and pain intensity as measured by the visual analogue scale (VAS). The sample consisted of 30 female patients with a definite diagnosis of RA and a functional capacity of class II. The results indicated that the pain fluctuated during the day. ⋯ A high correlation r = 0.86 (P less than 0.01) was found between the scores of RAI and present pain on the VAS. This finding suggests that the pain in RA is associated with the hyperalgesic state induced by the inflammatory condition associated with RA. There was no significant correlation between blood tests like ERS, WBC and VAS or RAI.