Aspects of Pain, Its Assessment and Evaluation from An Acupuncture Perspective

2006 ◽  
Vol 24 (3) ◽  
pp. 109-117 ◽  
Author(s):  
Iréne Lund ◽  
Thomas Lundeberg
Keyword(s):  
Pain Assessment ◽  
Individual Variation ◽  
Rating Scales ◽  
Pain Treatment ◽  
Clinical Problem ◽  
Self Report ◽  
Assessment And Evaluation ◽  
Metric Properties ◽  
Perceived Pain ◽  
The Individual

Pain is a major clinical problem that causes great suffering for the individual and incurs costs for society. Accurate assessment and evaluation of perceived pain is necessary for diagnosis, for choice of treatment, and for the evaluation of treatment efficacy. The assessment of an individual's pain is a challenge since pain is a subjective, multidimensional experience, and assessment is based on the person's own self-report. The results are often varied, possibly due to inter-individual variation, but also in relation to gender and aetiology. A gold standard for pain assessment is still lacking, but rating scales, questionnaires, and methods derived from psychophysical concepts, such as threshold assessments and perceptual matching, are used. In the evaluation of pain and associated variables, both systematic and individual variation should be taken into account, as should pain-associated symptoms. Recommendations for pain treatment should be based on the patient's specific needs. Therefore, it is important to assess the level of perceived pain taking individual variation into account. The methods used should preferably have proved to be useful in randomised controlled trials, and analysis of pain assessment should consider its non-metric properties. In the future, the use of studies with a naturalistic protocol together with individual assessment of individual pain responses could increase the internal and external validity.

Treatment Recommendations Should Take Account of Individual Patient Variation Not Just Group Responses

2009 ◽  
Vol 27 (1) ◽  
pp. 31-32 ◽  
Author(s):  
Thomas Lundeberg ◽  
Iréne Lund
Keyword(s):  
Statistical Analysis ◽  
Individual Variation ◽  
Treatment Effects ◽  
Treatment Recommendations ◽  
Self Report ◽  
Controlled Trials ◽  
Metric Properties ◽  
Systematic Effects ◽  
The Individual ◽  
Randomised Controlled

Recommendations for treatment are commonly based on results evaluating variation in systematic effects (group responses) from randomised controlled trials without taking the individual patient's variation into account. In the evaluation of acupuncture-related treatment effects, the trial design and statistical analysis used are a challenge since the assessed variables commonly have subjective properties and are based on the person's own self-report. Thus, the results that are seen are often varied, most likely due to inter-individual variation in rating of the actual variable such that the treatment effects are expressed more (or less) in some individuals than in others. The basis for the individual variation is probably multi-modal and could be related to the individuals’ expectation, gender, genetic polymorphisms and the aetiology of the condition. The assessment methods used should preferably have proven useful in controlled trials, and the methods for statistical analysis should consider the non-metric properties of the variable and the contribution of the individuals’ variation in the results. In order to evaluate the treatment effects more properly and increase the possibility of detecting any effectiveness, it is therefore important to assess the level of perceived dysfunction or symptom, taking into account the individual variation as well as the systematic effects (the effects of the group). In the evaluation of acupuncture effects, both systematic and individual variation should be reported allowing for the detection of subgroup effects and thereby leading to treatment recommendations that are more likely to be based on each individual's specific needs.

scholarly journals Assessing children’s defense mechanisms with the Defense Mechanisms Rating Scales Q-sort for Children

2021 ◽  
Vol 24 (3) ◽  
Author(s):  
Mariagrazia Di Giuseppe ◽  
Tracy A. Prout ◽  
Lauren Ammar ◽  
Thomas Kui ◽  
Ciro Conversano
Keyword(s):  
Defense Mechanisms ◽  
Rating Scales ◽  
Rating Scale ◽  
Child Psychotherapy ◽  
Self Report ◽  
Ample Evidence ◽  
Defensive Functioning ◽  
Mental Health Literature ◽  
The Individual ◽  
Q Sort

Defense mechanisms are unconscious and automatic psychological processes that serve to protect the individual from painful emotions and thoughts. There is ample evidence from the adult psychotherapy and mental health literature suggesting the salience of defenses in the maintenance and amelioration of psychological distress. Although several tools for the assessment of children’s defenses exist, most rely on projective and self-report tools, and none are based on the empirically derived hierarchy of defenses. This paper outlines the development of the defense mechanisms rating scale Q-sort for children (DMRS-Q-C), a 60-item, observer-rated tool for coding the use of defenses in child psychotherapy sessions. Modifications to the Defense Mechanisms Rating Scale Q-Sort for adults to create a developmentally relevant measure and the process by which expert child psychotherapists collaborated to develop the DMRS-Q-C are discussed. A clinical vignette describing the child’s defensive functioning as assessed by the innovative DMRS-Q-C method is also reported. Finally, we provide an overview of forthcoming research evaluating the validity of the DMRS-Q-C.

scholarly journals Pain assessment and registration in medical oncology clinics: operationalised through the lens of health care professionals and patients

2021 ◽  
Vol 4 ◽  
pp. 86
Author(s):  
Laserina O'Connor ◽  
Aileen Hassett ◽  
Noeleen Sheridan
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Cancer Treatment ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Medical Oncology ◽  
Pain Treatment ◽  
Self Report ◽  
Common Symptom

Background: Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease. Systematic screening and documentation of pain are necessary to improve the quality of cancer pain treatment, because a key pain-related barrier is that patients are reluctant to discuss pain, due to fear that reporting pain will distract the healthcare professional from their cancer treatment. Methods: This study adopted an explanatory sequential mixed-methods design. Data collection incorporated three strands. The first strand involved a quantitative enquiry in which medical chart reviews of patients (n=100) attending the medical oncology outpatient clinic were examined. The second qualitative strand comprised of semi-structured interviews with patients (n=10) attending that service. The third strand was qualitative and consisted of focus group discussions with healthcare professionals (n=12). Results: All 100 patients had cancer. The quantitative findings confirmed the suboptimum assessment and subsequent recording of patient’s pain, that seemed to afford a reality check for all healthcare professionals. For patients, the outcomes of the anti-cancer treatment were their priority, and pain was perceived as inevitable, being associated with a cancer diagnosis. There were multifaceted complexities voiced amongst healthcare professionals associated with balancing the benefits and harms aligned with treating cancer pain. Conclusions: Pain assessment in medical records was not systematically recorded by healthcare professionals. Patients were reluctant to self-report pain during their medical oncology outpatient review. The expectation that patients will self-report pain can be accommodated by healthcare professionals if a personalized pain goal is part of the cancer pain management plan during each clinical encounter. Healthcare professionals reported a need to take distinct responsibility for supplementing their dearth of knowledge, skills and beliefs regarding assessing and managing patients’ cancer pain. Optimal pain management stems from an interprofessional approach that was applied in this study design.

scholarly journals ABOUT THE PAIN IN CHILDREN

2019 ◽  
Vol 32 (2) ◽  
pp. 281-284
Author(s):  
Svetla Ivanova
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Pain Treatment ◽  
Emotional Experience ◽  
Behavioral Assessment ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Self Report ◽  
Pediatric Care ◽  
First Pain

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain for pediatric patients is more difficult to evaluate and treat than in adults. Its assessment and management are key components of pediatric care which aim to reduce subjective sensation and to improve the satisfaction of medical specialists and parents. The assessment of pain depends on the cognitive development of the child , the clinical context and the type of pain. Pain management in children improves physiological, behavioral and hormonal results, leads to faster recovery, less complications, and reduced healthcare resources. Ineffective and untimely treatment of pain in children can cause long-lasting physical and psychological consequences. This article aims to determine the importance of adequate pain control in children. For children over the age of 6, pain assessment is based on self-assessment, whereas children under the age of 6 require behavioral scales for pain assessment. Behavioral assessment scales include child monitoring as well as basic characteristics of pain such as intensity, location, duration. The nurses are in a position to meet the child's first pain caused by fear and anxiety in the hospital, but parents who take care of the child are an important assistant in assessing, especially in children with special needs. Some children may find it difficult to do a distinction between pain, anxiety and stress. Effective pain assessment leads to more satisfied children and families. Prolonged inadequate treatment of pain in children may be due to the lack of knowledge and failure of nurses to appreciate and manage pain effectively. Medical specialist should be able to detect the symptoms and signs of pain in different age groups and determine whether these symptoms are caused by pain or other factors. The methods used for pain assessment have proven clinical efficacy, reliability and usability, making them an integral part of the treatment and management of pain. Three are the ways to measure it in children: self-report, behavioral evidence, and physiological-clinical observations. After processing the collected information, the data are entered into the required documentation which provides continuous ,safe and qualified care. Documentation of the children’s pain is a key factor in pain managing. Low level of nurses’ knowledge of assessing pain, inappropriate use of pain scales or lack of documentation could affect pain treatment. Assessment is performed if a child complains of pain, after surgery, if a procedure would cause discomfort or at least once a shift to check if children have any pain. The main subject of pain management strategy is pain prevention and modification of techniques used for diagnostic procedures for infant.

Articles Published in EJPA 2009–2010

2011 ◽  
Vol 27 (4) ◽  
pp. 290-298 ◽  
Author(s):  
Tuulia M. Ortner ◽  
Isabella Vormittag
Keyword(s):  
Psychological Assessment ◽  
Rating Scales ◽  
Self Report ◽  
Related Field ◽  
Broad Scope ◽  
Future Challenges ◽  
Health Related ◽  
Report Data ◽  
Self Report Data

With reference to EJPA’s unique and broad scope, the current study analyzed the characteristics of the authors as well as the topics and research aims of the 69 empirical articles published in the years 2009–2010. Results revealed that more than one third of the articles were written by authors affiliated with more than one country. With reference to their research aims, an almost comparable number of articles (1) presented a new measure, (2) dealt with adaptations of measures, or (3) dealt with further research on existing measures. Analyses also revealed that most articles did not address any particular field of application. The second largest group was comprised of articles related to the clinical field, followed by the health-related field of application. The majority of all articles put their focus on investigating questionnaires or rating scales, and only a small number of articles investigated procedures classified as tests or properties of interviews. As to further characteristics of the method(s) used, a majority of EJPA contributions addressed self-report data. Results are discussed with reference to publication demands as well as the current and future challenges and demands of psychological assessment.

Schmerztherapie nach thoraxchirurgischen Eingriffen

2018 ◽  
Vol 12 (02) ◽  
pp. 155-165
Author(s):  
Holger Hendrix ◽  
Vladimir Kamlak ◽  
Georgi Prisadov ◽  
Katrin Welcker
Keyword(s):  
Thoracic Surgery ◽  
Pain Therapy ◽  
Pain Treatment ◽  
Internal Standards ◽  
Pain Experience ◽  
Thoracic Surgical Procedures ◽  
Therapeutic Algorithm ◽  
Alternative Procedures ◽  
The Individual ◽  
Documentation Form

The treatment of pain after thoracic surgery is a challenge and takes place in the individual clinics mostly according to clinic internal standards. It exists no currently valid S3 guideline for the treatment of acute perioperative and posttraumatic pain. For an effective pain treatment as well individual pain experience as the pain intensity of the various thoracic surgical procedures must be considered. Regular pain assessment with appropriate methods and their documentation form the basis for adequate and adapted pain therapy.There are a number of different pain therapy methods, non-medicamentous and drug-based methods, whose effectiveness is described in the literature partially different. For the treatment of acute postoperative pain after thoracic surgery, mainly drug-related procedures are used, except for physiotherapy as a non-medicamentous method. Increasingly, alternative procedures for the peridural catheter as a therapeutic gold standard in the treatment of pain after thoracic surgery are used. Their application can be integrated into a therapeutic algorithm.

Inhibition tasks are not associated with self-regulation outcomes in healthy college students

2019 ◽  
Author(s):  
Curtis David Von Gunten ◽  
Bruce D Bartholow ◽  
Jorge S. Martins
Keyword(s):  
Latent Variable ◽  
Convergent Validity ◽  
Self Regulation ◽  
Poor Performance ◽  
Self Control ◽  
Self Report ◽  
Life Outcomes ◽  
Variable Level ◽  
Cast Doubt ◽  
The Individual

Executive functioning (EF) is defined as a set of top-down processes used in reasoning, forming goals, planning, concentrating, and inhibition. It is widely believed that these processes are critical to self-regulation and, therefore, that performance on behavioral task measures of EF should be associated with individual differences in everyday life outcomes. The purpose of the present study was to test this core assumption, focusing on the EF facet of inhibition. A sample of 463 undergraduates completed five laboratory inhibition tasks, along with three self-report measures of self-control and 28 self-report measures of life outcomes. Results showed that although most of the life outcome measures were associated with self-reported self-control, none of the life outcomes were associated with inhibition task performance at the latent-variable level, and few associations were found at the individual task level. These findings challenge the criterion validity of lab-based inhibition tasks. More generally, when considered alongside the known lack of convergent validity between inhibition tasks and self-report measures of self-control, the findings cast doubt on the task’s construct validity as measures of self-control processes. Potential methodological and theoretical reasons for the poor performance of laboratory-based inhibition tasks are discussed.

Indices and Correlates of Positive Emotion in Psychopathology

2019 ◽  
pp. 95-118
Author(s):  
Sunny J. Dutra ◽  
Marianne Reddan ◽  
John R. Purcell ◽  
Hillary C. Devlin ◽  
Keith M. Welker
Keyword(s):  
Positive Emotion ◽  
Self Report ◽  
Individual Level ◽  
Advantages And Disadvantages ◽  
Innovative Methods ◽  
Behavioral Coding ◽  
Broad Array ◽  
Positive Valence ◽  
The Individual ◽  
Clinical Populations

This chapter not only draws from previous authoritative measurement overviews in the general field of emotion, but also advances these resources in several key ways. First, it provides a specific focus on positive valence systems, which have not yet received specific methodological attention. Second, the field of positive emotion (PE) has expanded in recent years with new and innovative methods, making an updated review of methodological tools timely. Third, the chapter incorporates discussion of PE disturbance in clinical populations and the methods best suited to capture PE dysfunctions. This chapter also outlines some tools that can allow researchers to capture a broad array of PE quantified by self-report, behavioral coding, and biological correlates as seen through changes in the central and peripheral nervous system (i.e., brain and body). After reviewing PE measurement methods and correlates, this chapter includes several methods for studying PE beyond the individual level (i.e., interpersonal) and traditional laboratory settings (i.e., ambulatory or experience sampling). It provides key examples of their applications to study PE in clinical populations while acknowledging several of their basic advantages and disadvantages.

Intra-individual variation in adults and children: measuring and conceptualizing individual dialect–standard repertoires

2021 ◽  
Vol 7 (s2) ◽  
Author(s):  
Irmtraud Kaiser ◽  
Andrea Ender
Keyword(s):  
Language Acquisition ◽  
Individual Variation ◽  
The Other ◽  
Standard Language ◽  
Methodological Choices ◽  
Standard Spectrum ◽  
Speech Data ◽  
Adults And Children ◽  
The One ◽  
The Individual

Abstract This paper explores intra-individual variation as a manifestation of language-internal multilingualism in the Central-Bavarian Austrian context. Based on speech data from children and adults in different contexts, we discuss different methods of measuring and analyzing inter-situational variation along the dialect and standard language spectrum. By contrasting measures of dialectality, on the one hand, and proportions of turns in dialect, standard language or intermediate/mixed forms on the other, we gain complementary insights not only into the individual dialect-standard repertoires but also into the consequences of different methodological choices. The results indicate that intra-individual variation is ubiquitous in adults and children and that individual repertoires need to be taken into account from the beginning of the language acquisition process. We suggest that while intra-individual variation can be attested through the use of various methods, the revealed level of granularity and the conclusions that can be drawn as to the individual repertoires on the dialect-standard spectrum largely depend on the measures used and their inherent assumptions and intrinsically necessary categorizations.

An experimental approach to communal coping

2021 ◽  
pp. 026540752199246
Author(s):  
Melissa Zajdel ◽  
Vicki S. Helgeson
Keyword(s):  
Health Outcomes ◽  
Positive Relationship ◽  
Experimental Approach ◽  
Positive Mood ◽  
Self Report ◽  
Communal Coping ◽  
Observational Measures ◽  
Relationship Outcomes ◽  
The Individual

Communal coping has been linked to better psychological and physical health across a variety of stressful contexts. However, there has been no experimental work causally linking communal coping to relationship and health outcomes. In addition, research has emphasized the collaboration over the shared appraisal component of communal coping. The present study sought to isolate the role of appraisal by manipulating whether dyads viewed a stressor as shared or individual. Friend dyads (n = 64 dyads; 128 participants) were randomly assigned to view a stressor as either a shared or an individual problem, but both groups were allowed to work together. Across self-report and observational measures dyads reported more collaboration and support, better relationship outcomes, and more positive mood after the stressor in the shared than the individual appraisal group. This is the first laboratory evidence to establish causal links of communal coping—specifically shared appraisal—to positive relationship and health outcomes.

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