ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Objective:A variety of instruments have been applied to the measurement of activity, yet few, if any, have been validated specifically for older people with chronic pain. This study has sought to examine the utility of the Human Activity Profile (HAP) for describing activity in a sample drawn from a pain clinic for older people.Design:The HAP was administered to 193 older pain clinic patients, 72 of whom completed the profile on a second occasion. A further 55 responses were collected from a group of community-dwelling volunteers. The factor structure of the HAP was tested using these 320 responses. The factors subsequently derived were compared with the Sickness Impact Profile (SIP) and the Barthel Index (BI). The discriminant validity of the HAP was examined by comparing factor scores for groups determined by gender, diagnosis, and status in the pain clinic.Results:The 94 items of the HAP loaded onto 10 factors, which explained 63.7% of the variance. These factors demonstrated moderate associations with the BI and the subscales of the SIP. The factors discriminated between men and women (F[12,180] = 9.85, p < 0.000). Differences were also present between subjects with a musculoskeletal pain problem, postherpetic neuralgia, and pain-free volunteers (F[24,340] = 4.7, p < 0.000). Factor scores increased between pre- and postclinic assessments (F[12,60] = 4.79, p < 0.000).Conclusions:The HAP has demonstrated qualities which favor its adoption as an activity measure for older pain clinic patients.

ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Objective:Inadequate assessment of pain in premature infants is a persistent clinical problem. The objective of this research was to develop and validate a measure for assessing pain in premature infants that could be used by both clinicians and researchers.Design:The Premature Infant Pain Profile (PIPP) was developed and validated using a prospective and retrospective design. Indicators of pain were identified from clinical experts and the literature. Indicators were retrospectively tested using four existing data sets.Patients and Settings:Infants of varying gestational ages undergoing different painful procedures from three different settings were utilized to develop and validate the measure.Methods and Results:The largest data set (n = 124) was used to develop the PIPP. The development process included determining the factor structure of the data, developing indicators and indicator scales and establishing internal consistency. The remaining three data sets were utilized to establish beginning construct validity.Conclusions:The PIPP is a newly developed pain assessment measure for premature infants with beginning content and construct validity. The practicality and feasibility for using the PIPP in clinical practice will be determined in prospective research in the clinical setting.

ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Objective:To investigate the extent to which gender differences in the expression of depressive symptomatology exist among chronic pain patients.Setting:A multidisciplinary pain center affiliated with a state medical school in the southern United States.Patients:A total general sample of 245 patients with heterogeneous chronic pain complaints randomly selected from a database of ≈1,000 pretreatment evaluation patient files. A depressed subsample of 113 patients based on scores ≥15 on the Beck Depression Inventory (BDI).Measure:The 21-item BDI.Results and Conclusions:Gender differences in total BDI scores were not revealed for the total general sample or depressed subsample, but gender differences in the expression of depressive symptoms (i.e., item level responses) were found via separate discriminant function analyses on the total general sample and depressed subsample. Consistent with previous studies performed on diverse samples, females' higher endorsement of body image distortion was noted in both of our samples. Females also endorsed significantly higher levels of fatigue in our total sample. Items that were not significant in our total sample include females' higher levels of loss of appetite and crying. In the depressed subsample, items probing pessimism and failure were not statistically significantly different to males' endorsing higher levels of each. Sensitivity to these gender differences is suggested in clinical practice. The likely consequences that these differences in the experience and expression of distress have on coping activities (e.g., help-seeking responses) and the reactions of others (e.g., health-care providers) are highlighted.

ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Objective:The aim of the study was to investigate the role played by anatomical (lower limb length discrepancy) and biomechanical (alterations in the dynamics of movement) factors in the pathophysiology of myofascial pain syndrome (MPS) of the peroneus longus.Design:Patients affected with MPS of the peroneus longus of one side were submitted to either correction of their lower limb discrepancy by heel lift (6 patients) or normalization of altered biomechanical parameters during movement, as measured via ground-foot reaction analysis (g-f) by dynamic insoles (6 patients) for 60 days. At days 7, 15, 30, and 60, the effect of treatment was verified on painful symptoms [VAS scale, presence of the active trigger point (TrP) in the muscle] and on g-f parameters [peaks of vertical force (F1 and F3 of Fz) and of lateral shear force (Fx)].Results:Treatment with heel lift produced a moderate, significant reduction of the spontaneous pain and of the abnormal Fx peak in the affected leg after 7 to 14 days with no further improvement afterward. Treatment with dynamic insoles caused a marked, significant reduction of the pain at 7 days, with complete resolution of the painful symptoms at 30 days and concomitant disappearance of the active TrP in the muscle. It also produced a significant and progressive reduction of the abnormal Fx peak in the affected leg starting at the 7th day and continuing until the 60th day.Conclusion:Both anatomical and biomechanical alterations of the dynamics of movement play a role in the painful symptoms of MPS of the peroneus longus, but the biomechanical factor is by far the more prominent.

ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Objective:The determination of the changes in the incidence and stressfulness of daily hassles as well as in the mood states: alert, tense, irritable, annoyed, depressed, and tired and in the quality of sleep in the 2 days before a migraine headache.Design:Prospective cohort study.Setting:Private headache practice.Patients:Twenty female migraine patients.Interventions:Diary four times per day for 10 consecutive weeks with the variables quantified through the use of 100-mm visual analogue scales.Results:The incidence and stressfulness of daily hassles as well as the mood states: tense, irritable, annoyed, depressed, and tired were significantly increased in the 2 days before a migraine headache in comparison to control days.Conclusions:The results confirm previous studies that daily hassles are increased in the days before a migraine headache. They also show that the increase in daily hassles is associated with mood changes, particularly consisting of tension and depression.

ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Objective:The analysis of patient data concerning psychological structure and functioning produced an instrument to determine whether a neurostimulator ought to be implanted or not.Design:A questionnaire containing 24 items was developed by a psychologist and tested in 40 chronic failed back surgery patients for whom a spinal cord stimulation seemed to be the only therapeutic approach. This questionnaire was based upon some crucial psychological themes, on which the patient took a position. A predictive indication factor (I.F.;%) for implantation of the neurostimulator was obtained from the 24 items. Six months after the implantation of the neurostimulator, we correlated the evaluation factor (E.F.;%) with a six-point evaluation scale considering the pain reduction. The aim was to compare the I.F. and E.F. to verify the correlation between them. This comparison was intended to answer the question if psychological variables included in our scale improve the success rate of the therapy.Setting:Data were collected by a psychologist at the Pain Clinic of the University Hospital of Gent, Belgium.Results and Conclusions:The correlation between the I.F. and the E.F. was calculated for the 40 patients by the Spearman correlation test. A coefficient value of 0.8083 (p = 0.000) was found, indicating the existence of a very close correlation between the predictive I.F. and the E.F. The indication scale appears to be a useful instrument for clinical psychologists to predict the success rate of a spinal cord stimulator in this group of patients.

ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Objective:Long-term pain is a common sequela of thoracotomy, occurring in approximately 50% of patients 2 years after thoracic surgery. Despite this alarming statistic, little is known about the factors responsible for the transition of acute to chronic pain. The aim of the present study is to identify predictors of long-term post-thoracotomy pain.Design:Follow-up was for 1.5 years for patients who had participated in a prospective, randomized, controlled trial of preemptive, multimodal analgesia.Setting:Subjects were recruited from a tertiary care center.Patients:Thirty patients who had undergone lateral thoracotomy were followed up by telephone, administered a structured interview, and classified according to long-term pain status.Main Outcome Measures:Present pain status was measured by a verbal rating scale (VAS). Measures obtained within the first 48 h after surgery were compared between patients with and without pain 1.5 years later. These include VAS pain scores at rest and after movement, McGill Pain Questionnaire data, patient-controlled morphine consumption (mg), and pain thresholds to pressure applied to a rib contralateral to the thoracotomy incision.Results:Fifty-two percent of patients reported long-term pain. Early post-operative pain was the only factor that significantly predicted long-term pain. Pain intensity 24 h after surgery, at rest, and after movement was significantly greater among patients who developed long-term pain compared with pain-free patients. A significant predictive relationship was also found at 24 and 48 h using the McGill Pain Questionnaire. Cumulative morphine was comparable for the two groups. Pain thresholds to pressure applied to a rib contralateral to the incision did not differ significantly between the groups.Conclusion:Aggressive management of early postoperative pain may reduce the likelihood of long-term post-thoracotomy pain.

ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Objective:This is a report of a trial of the new antiepileptic agent gabapentin in patients with intractable neuropathic pain.Design:A case series of patients with a diagnosis of neuropathic pain whose previous management was inadequate were given oral gabapentin in increasing doses and were followed for a minimum of 2 months, monitored for efficacy and side effects.Setting:An outpatient pain management center located within a major university medical center.Patients:Convenience sample of patients referred for management of intractable neuropathic pain.Interventions:Simplification of existing pharmacologic management, addition of gabapentin, and attempted reduction of opiate analgesic doses.Main Outcome Measures:Patient self-reports and pain scores in successive office visits.Results:Gabapentin provides analgesic activity for patients with neuropathic pain and has the advantage of a low side effect profile and drug toxicity.

ISSN:0749-8047    

出版商:OVID    

年代:1996

数据来源: OVID