摘要:

ObjectivesTo determine whether caregivers of children with cognitive impairment (CI) have systematic beliefs regarding the pain of this special group of children and whether these beliefs are related to their general attitudes towards people with mental challenges, or their experience with, or knowledge about, children with CI.ParticipantsSixty-five caregivers (52 parents and 13 health care providers) of children with significant CI.MeasuresCaregivers completed the Mental Retardation Attitude Inventory-Revised and provided information regarding their previous experience and learning about children with CI. They also completed the Pain Opinion Questionnaire, indicating the percentage of children with mild, moderate, or severe/profound CI that they believe experience 5 facets of pain “less than”, “the same as”, or “more than” children without CI: sensation, emotional reaction, behavioral reaction, communication, and frequency.ResultsCaregivers believed children's pain Sensation becomes greater, relative to children without CI, as severity of CI increases and that pain reaction is most consistent with pain sensation for children with severe CI. They also believed children with mild CI may over-react to pain. Caregivers' beliefs regarding pain were not influenced by their general attitudes about people with mental challenges or by their experience with children with CI, but those with more learning regarding children with CI believed that they experience pain less than children without CI.ConclusionsCaregivers have a priori beliefs regarding pain in children with CI that vary with level of cognitive impairment and pain facet. These beliefs could impact children's care.

ISSN:0749-8047    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Because of the importance of pain assessment to understanding the nature and scope of pain problems, and for testing the efficacy of pain treatments, new pain measures are frequently developed. Research that describes the development and evaluation of pain measures should include detailed information concerning the validity and reliability of the measures. However, for the findings from this research to be most useful, the consumers of this research (clinicians and researchers who use pain measures) should understand the concepts of validity and reliability, and the procedures used for evaluating these in pain assessment research. The purpose of this commentary is to provide a summary of these psychometric issues, using the study and findings of Krause and Backonja as an illustrative example of the concepts.

ISSN:0749-8047    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveThe objectives of this study were to: (1) evaluate the validity of the Neonatal Facial Coding System (NFCS) for assessment of postoperative pain and (2) explore whether the number of NFCS facial actions could be reduced for assessing postoperative pain.DesignProspective, observational study.PatientsThirty-seven children (0–18 months old) undergoing major abdominal or thoracic surgery.Outcome MeasuresThe outcome measures were the NFCS, COMFORT “behavior” scale, and a Visual Analog Scale (VAS), as well as heart rate, blood pressure, and catecholamine and morphine plasma concentrations. At 3-hour intervals during the first 24 hours after surgery, nurses recorded the children's heart rates and blood pressures and assigned COMFORT “behavior” and VAS scores. Simultaneously we videotaped the children's faces for NFCS coding. Plasma concentrations of catecholamine, morphine, and its metabolite M6G were determined just after surgery, and at 6, 12, and 24 hours postoperatively.ResultsAll 10 NFCS items were combined into a single index of pain. This index was significantly associated with COMFORT “behavior” and VAS scores, and with heart rate and blood pressure, but not with catecholamine, morphine, or M6G plasma concentrations. Multidimensional scaling revealed that brow bulge, eye squeeze, nasolabial furrow, horizontal mouth stretch, and taut tongue could be combined into a reduced measure of pain. The remaining items were not interrelated. This reduced NFCS measure was also significantly associated with COMFORT “behavior” and VAS scores, and with heart rate and blood pressure, but not with the catecholamine, morphine, or M6G plasma concentrations.ConclusionThis study demonstrates that the NFCS is a reliable, feasible, and valid tool for assessing postoperative pain. The reduction of the NFCS to 5 items increases the specificity for pain assessment without reducing the sensitivity and validity for detecting changes in pain.

ISSN:0749-8047    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo assess the efficacy of acupuncture in the treatment of chronic low back pain.MethodsPatients (n = 60) with chronic low back pain were recruited and randomly allocated to either Acupuncture therapy or Placebo transcutaneous electrical nerve stimulation (TENS) groups. Patients were treated weekly for 6 weeks, and blinded assessments were carried out pre- and post-treatment using the McGill Pain Questionnaire (MPQ) and visual analog scales (VAS) for pain, the Short-form 36 quality-of-life questionnaire, and a simple range of motion measurement. A total of 46 patients completed the trial and were followed up at 6 months.ResultsAnalysis of results usingttests showed that in both groups there were significant pre-post improvements for all scores, except for MPQ scores in the Placebo-TENS group. There was no significant difference between the 2 groups for any of the outcome measures at the end of treatment. Results from the 6-month follow-up would suggest that the response was better in the acupuncture group.DiscussionFurther research is necessary to fully assess the efficacy of this treatment in combating chronic low back pain using larger sample sizes or alternative control groups.

ISSN:0749-8047    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectivesThe purpose of this investigation is to assess the evidence for efficacy of SCS in the management of pain in patients with CRPS.MethodsSearch strategy:Electronic databases such as Medline and Cochrane Library were queried using key words such as “spinal cord stimulation,” “reflex sympathetic dystrophy (RSD),” and “complex regional pain syndrome (CRPS).”Selection criteria:Relevant published randomized controlled trials (RCT), cohort studies, case-control studies, case series, and case reports that described SCS as the primary treatment modality for patients with CRPS were eligible for inclusion.Data collection and analysis:Data extracted from qualified studies were summarized in sections of methodology, demographics, SCS equipment, primary and secondary outcomes, and complications.ResultsThirteen studies using the primary search strategy and 7 studies from their reference lists were considered. Five of these 20 studies were discarded. One RCT, 2 prospective observational, and 12 retrospective observational studies were eventually considered. The methodological quality of all studies was poor except for the single RCT study.DiscussionAlthough limited in quality and quantity, available evidence from the examined literature suggests that SCS is effective in the management of pain in patients with CRPS (grade B/C). Clinically useful information extracted from the available studies is very limited in guiding clinicians in the rational use of SCS for pain management in CRPS patients. Future attempts to investigate the efficacy of SCS in CRPS patients should involve methodologically robust designs such as randomized studies that have sufficient power.

ISSN:0749-8047    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0749-8047    

出版商:OVID    

年代:2003

数据来源: OVID