ISSN:0749-8047    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objective:This study evaluated neonatal pain scales during procedures commonly performed in a neonatal intensive care unit.Design:Evaluated were the Neonatal Infant Pain Scale (NIPS), the Comfort scale, and a new scale known as the Scale for Use in Newborns (SUN). Four procedures were scored: intubation, intravenous catheter insertion, endotracheal tube suctioning, and diaper changes. Scoring was done before, during, and after each procedure. Thirty-three patients were tested during 68 procedures with 1,428 scale scores.Results:All scales demonstrated significant changes. In before-versus-during for each procedure, the increase in pain scale score was significant for the NIPS, Comfort scale, and SUN. All three scales also demonstrated a return to baseline (before-vs.-after) for the four procedures, except for the Comfort scale, which remained elevated (p< .05) following diaper change. The NIPS had a significantly larger coefficient of variation (CV, 188% ± 99%), whereas the Comfort scale and SUN had small CVs (27% ± 5% and 33% ± 8%, respectively). In evaluating potential confounding influences, it was found that infants >2.5 kg on sedative or analgesic medications appeared to have procedure-related accentuation and sustained elevation in scale scores, whereas swaddling seemed to provide little added benefit.Conclusions:The pain scale scores identify changes in an infant's behavior/physiologic state. It is unclear whether these changes are totally "pain specific." In comparing the three scales, the SUN overall was a preferable tool because of its ease of use, scale symmetry, and scoring consistency.

ISSN:0749-8047    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objective:To assess the ability of the International Association for the Study of Pain Complex Regional Pain Syndrome (CRPS) diagnostic criteria and associated features to discriminate between CRPS patients and patients with painful diabetic neuropathy.Design:Prospective assessment of signs and symptoms in a series of CRPS and diabetic neuropathy patients.Setting:University of Washington Multidisciplinary Pain Center.Patients:A consecutive series of 18 CRPS patients and 30 diabetic neuropathy patients.Interventions:Patients completed a 10-item patient history questionnaire assessing symptoms of CRPS prior to medical evaluation. The evaluating physician completed a 10-item patient examination questionnaire assessing objective signs of CRPS.Outcome Measures:The analyses conducted were designed to test the ability of CRPS signs and symptoms and associated features to discriminate between CRPS patients and diabetic neuropathy patients.Results:Data analysis suggested that CRPS decision rules may lead to overdiagnosis of the disorder. Diagnosis based on self-reported symptoms can be diagnostically useful in some circumstances. The addition of trophic tissue changes, range of motion changes, and "burning" quality of pain did not improve diagnostic accuracy, but the addition of motor neglect signs did. Test of a CRPS scoring system resulted in improved accuracy relative to current criteria and decision rules.Conclusions:Poorly understood disorders lacking prototypical signs/symptoms and diagnostic laboratory testing must rely on the development of reliable diagnostic guidelines. The results of this study should assist in the further refinement of the CRPS diagnostic criteria.

ISSN:0749-8047    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objective:This cross-sectional study evaluated the extent to which relations between employment status and emotional distress are mediated by pain-related and psychosocial measures among employed and unemployed persons with chronic pain.Design:A total of 40 unemployed and 43 employed persons reporting chronic pain were recruited from pain services at a tertiary-care hospital and community-based organizations. Volunteers completed self-report measures of pain severity, subjective financial stress, time structure, emotional distress, and background data.Results:A path analysis indicated that pain severity had direct associations with both emotional distress and employment status. In addition, employment status was only indirectly related to emotional distress; this relation was mediated by levels of reported financial strain and structured purposeful time use.Conclusions:Findings suggest that pain severity and the quality of specific experiences related to being employed or unemployed as opposed to employment status per se correspond directly to levels of emotional distress reported by some persons with chronic pain.

ISSN:0749-8047    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0749-8047    

出版商:OVID    

年代:1998

数据来源: OVID