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Local Anesthesia for Children
Published in Marwali Harahap, Adel R. Abadir, Anesthesia and Analgesia in Dermatologic Surgery, 2019
Thierry Pirotte, Francis Veyckemans
In the recent years, patterns of behavior (facial expression, body/limb movements and crying) have been increasingly studied. In neonates and small infants, pain-associated facial expressions allowed the development of so-called facial coding systems, such as the NFCS (Neonatal Facial Coding System) (16). Body movement in response to a painful stimulus can be used to assess pain in the preverbal child, but lack of movement does not always indicate the absence of pain; it may indicate a very high level of pain. Preschool children usually lack the verbal and cognitive skills to describe their feelings of pain or physical discomfort. Many creative tools have been developed to help them indicate the degree of their pain. Examples are drawings of faces, a photographic scale of facial expression, and a ladder scale. To help the care provider, many multidimensional composite measures have been developed such as: CHEOPS (17), TPPPS (18), and COMFORT (19). For older children and adolescents, visual analogue scales (VAS) have been shown to be reliable for pain measurement.
Life Care Planning for People with Chronic Pain*
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
A brief listing of unidimensional and multidimensional pain measurement tools would include (Ramamurthy et al., 2006): Unidimensional: Verbal Descriptor Scale, Visual Analogue Scale, Numerical Rating Scale, and Pain Relief ScaleMultidimensional: McGill Pain Questionnaire, Brief Pain Inventory, Dartmouth Pain Questionnaire, the Minnesota Multiphasic Personality Inventory, West-Haven–Yale Multidimensional Pain Inventory, and the Quebec Back Pain Disability Scale
Symptom Management and Physical Care
Published in Stephen R. Connor, Hospice and Palliative Care, 2017
Another cardinal rule in controlling pain is that, as mentioned above, pain is what the patient says is pain. The only one who can accurately measure pain and pain relief is the patient. Studies of surrogate measurement of pain find that medical staff and family do not give accurate ratings of pain when compared with the patient’s own ratings (Grossman, Sheidler, Swedeen, Mucenski, & Piantadosi, 1991; Teske, Dant, & Cleeland, 1983). Continuous titration of the patient’s medication dosage is critical to the control of pain. Hospice and palliative care nurses often use a pain measurement scale, such as a simple 0–10 scale, with 0 being pain free and 10 being the worst imaginable pain. Most patients want to be pain free, but some are quite content with keeping the pain at 3 or below on this scale. It is best to establish the patient’s goals for pain relief.
Pain, socioeconomic status and clinician assessments: a scoping review
Published in Journal of Social Distress and Homelessness, 2023
Three studies examined physician belief or agreement of self-reported pain, with varying results. In a cohort of 80 Brazilian patients described as predominantly female and poor, comparing physician and patient Visual Analogue Scales (VAS) – a pain measurement instrument in which 1 cm is equal to one point on a zero to ten point score – it was found that 43.7% of patients scored their disease activity higher than the physician when a difference of 1 cm was applied. This went down to 23.7% when a difference of 3 cm was applied. (Nicolau et al., 2004) This was in contrast to Radowsky et al’s findings, that there was no significant difference in pain scores reported by patients and their physician (Radowsky et al., 2012). Nampiaparampil et al’s vignette survey of 90 physicians examined differences between an expensively insured Caucasian man and a Medicaid insured black man with lower back pain. They found that on a scale of 1-10, when asked how likely physicians thought the fictional patient was to be exaggerating their symptoms, the mean answer was 4.0 with a standard deviation of 1.9 (Nampiaparampil et al., 2009) which was consistent among the patient cohorts. Disturbingly, this finding suggests that many physicians suspect patients complaining of pain to be exaggerating their symptoms to some degree regardless of patient behaviors.
Generalized joint hypermobility and risk of pelvic girdle pain in pregnancy: does body mass index matter?
Published in Physiotherapy Theory and Practice, 2022
Hilde Stendal Robinson, Anne Lindgren, Elisabeth Krefting Bjelland
Pelvic girdle pain is usually reported to be less intense in the morning and to increase in intensity during daily activities (Larsen et al., 1999). Thus, we used evening pain measured by a VAS as our main outcome variable. The pain VAS has shown to be a reliable, responsive and valid tool to assess pain intensity (Dworkin et al., 2005; Ferreira-Valente, Pais-Ribeiro, and Jensen, 2011; Grotle, Brox, and Vollestad, 2004). To our knowledge, the VAS has not yet been tested in a population of women with pregnancy-related pelvic girdle pain. Furthermore, the VAS is uni-dimensional and cannot capture the various dimensions of pain. However, the pain VAS may have better ratio-scale properties than other uni-dimensional pain measurement scales (Ferreira-Valente, Pais-Ribeiro, and Jensen, 2011).
The association between pain intensity and disability in patients with failed back surgery syndrome, treated with spinal cord stimulation
Published in Disability and Rehabilitation, 2021
Mats De Jaeger, Lisa Goudman, Sam Eldabe, Robert Van Dongen, Ann De Smedt, Maarten Moens
Pain relief is the most frequently reported outcome variable when documenting pain treatment results in the literature. However, pain (and pain intensity) is a complex and subjective concept, posing several measurement challenges [1]. One commonly used unidimensional tool is the numerical rating scale (NRS), which scores pain intensity on a 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable). As an alternative to the NRS, a visual analog scale (VAS) may be used, but the NRS has the advantage of being enquired verbally [1–3]. However, these pain measurements present several methodological issues such as, a single snapshot measurement versus a pain diary, recollection difficulties and the subjective nature of pain measurement. Additionally, these questionnaires are relying on the self-reporting of patients, which make them subjective markers of pain. Despite those difficulties, these and other approaches are often used to collect useful information about pain intensity in clinical practice. The next challenge consists of how these pain intensity scores relate to “pain relief”. As pain relief is frequently used as an interpretation of the quality of a specific pain treatment [4]. Up till now, the different ways of reporting on pain intensity and pain relief resulted in different interpretations of important terms, such as responders, non-responders, and remitters [5,6].