Measuring Pain in Outpatient Surgical Patients: Variation Resulting from Instrument Choice

2012 ◽  
Vol 78 (11) ◽  
pp. 1292-1296 ◽  
Author(s):  
David Goodyear ◽  
Vic Velanovich
Keyword(s):  
Chronic Pain ◽  
Acute Pain ◽  
Linear Regression Analysis ◽  
Bodily Pain ◽  
Pain Scale ◽  
Surgical Patients ◽  
P Value ◽  
Sf 36 ◽  
Chronic Pain Patients ◽  
Pain Patients

Our hypothesis is that the type of instrument will affect variation in pain assessment. A sample of 269 patients administered the visual analog pain scale (VAS) and the generic quality-of-life instrument, and the SF-36 were evaluated for gender, age, the VAS score and the bodily pain domain of the SF-36 (BP-SF-36) score, primary surgical diagnosis, preoperative or postoperative status, and type of operation. Patients were grouped into preoperative (Preop) and postoperative (postop) status and those with chronic pain (CP) conditions and acute/no pain (AP) conditions. Linear regression analysis showed statistically significant (all P value ≤ 0.0006) correlations between the VAS and BP-SF-36 scores all patients, preoperative patients, postoperative patients, acute pain patients, and chronic pain patients. However, the strength of these correlations were moderate (r values between 0.51 and 0.61). Preoperative had more pain compared with postoperative patients as measured by both the VAS and BP-SF-36 ( P = 0.05). Similarly, chronic pain patients had more pain compared with acute pain patients as measured by both scales ( P < 0.0001). Although there are statistically significant associations between the BP-SF-36 and VAS, the correlations are moderate. Different instruments may measure different aspects of pain and the precision with which pain is measured in surgical patients.

scholarly journals The Effect of Social Observational Learning, Empathy and Catastrophizing in Chronic Pain Patients During Acute Pain Induction

Pain Medicine ◽  
2016 ◽  
pp. pnw186
Author(s):  
Dmitry Y. Yakunchikov ◽  
Camille J. Olechowski ◽  
Mark K. Simmonds ◽  
Michelle J. Verrier ◽  
Saifudin Rashiq ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Acute Pain ◽  
Observational Learning ◽  
Chronic Pain Patients ◽  
Pain Patients

Postoperative Pain Trajectories in Chronic Pain Patients Undergoing Surgery: The Effects of Chronic Opioid Pharmacotherapy on Acute Pain

2011 ◽  
Vol 12 (12) ◽  
pp. 1240-1246 ◽  
Author(s):  
C. Richard Chapman ◽  
Jennifer Davis ◽  
Gary W. Donaldson ◽  
Justin Naylor ◽  
Daniel Winchester
Keyword(s):  
Chronic Pain ◽  
Postoperative Pain ◽  
Acute Pain ◽  
Chronic Pain Patients ◽  
Pain Trajectories ◽  
Pain Patients

scholarly journals Prevalence Comparisons of Somatic and Psychiatric Symptoms Between Community Nonpatients Without Pain, Acute Pain Patients, and Chronic Pain Patients

Pain Medicine ◽  
2015 ◽  
Vol 16 (1) ◽  
pp. 37-50 ◽  
Author(s):  
David A. Fishbain ◽  
Jinrun Gao ◽  
John E. Lewis ◽  
Daniel Bruns ◽  
Laura J. Meyer ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Acute Pain ◽  
Psychiatric Symptoms ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Locus Coeruleus Integrity in Older Adults with and without Chronic Pain

2021 ◽  
Author(s):  
Tyler R Bell ◽  
Carol E Franz ◽  
Lisa T Eyler ◽  
Christine Fennema-Notestine ◽  
Olivia K Puckett ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Locus Coeruleus ◽  
Bodily Pain ◽  
Pain Scale ◽  
Community Dwelling ◽  
Third Wave ◽  
Sf 36 ◽  
Mri Scans ◽  
Cortical Regions

The locus coeruleus (LC) is a brainstem region involved in regulating pain. Chronic pain is common in older adulthood, but no studies have examined its association with the LC in humans. We used neuromelanin-sensitive imaging to study differences in LC integrity in older adults with and without chronic pain. Chronic pain was assessed in community-dwelling men from the Vietnam Era Twin Study of Aging (VETSA) in 3 study waves covering an average of 12 years. Pain was self-reported on the SF-36 Bodily Pain Scale. Chronic pain was defined as moderate to severe pain severity at the current and at least one prior wave; 17% had chronic pain (n=80). At the third wave, 481 participants (mean age=67.57) underwent neuromelanin-sensitive MRI scans from which we calculated an LC contrast-to-noise ratio (LCCNR) - an index of LC integrity. We examined associations between chronic pain and LCCNR (in the rostral LC and caudal regions) with generalized estimating equations after adjusting for age, race, education, depressive symptoms, medical comorbidities, and opioid medication use. Individuals with chronic pain had .35 standard deviation lower rostral LCCNR (95% CI: -.62 to -.05) compared to those without chronic pain. No differences in the caudal LCCNR were detected. Chronic pain was associated with decreased rostral LC integrity in older adults. Differences in the rostral LC, rather than caudal LC, suggest the association between lower LC integrity and chronic pain may be related to pain processing in cortical regions where rostral LC projections typically connect.

scholarly journals Examination of Symptom Clusters in Acute and Chronic Pain Patients

2014 ◽  
Vol 3;17 (3;5) ◽  
pp. E349-E357
Author(s):  
David Fishbain
Keyword(s):  
Chronic Pain ◽  
Acute Pain ◽  
Severe Pain ◽  
Somatic Symptoms ◽  
The United States ◽  
Symptom Clusters ◽  
Pain Level ◽  
Cluster Number ◽  
Chronic Pain Patients ◽  
Pain Patients

Background: Symptom clusters have not been previously explored in acute pain patients (APPs) and chronic pain patients (CPPs) with non-cancer pain. Objectives: The objectives of this study were to determine in CPPs and APPs which somatic and non-somatic symptoms cluster with each other, the number of clusters, and if cluster number and cluster symptom makeup differ by pain level. Study Design: Study sample was 326 APPs and 341 CPPs who had completed a pool of questions that had included current symptom questions other than pain. Symptom cluster analyses were performed on 15 somatic and non-somatic symptoms for APPs and CPPs and for 2 CPP subgroups with moderate and severe pain. Setting: APPs and CPPs were from rehabilitation facilities located in 30 states in all geographical regions of the United States. Results: APPs had 4 symptom clusters and CPPs had 5. For CPPs, the clusters represented memory, neurological, behavioral, somatic, and autonomic problems. CPPs with moderate and severe pain had 3 and 4 symptom clusters, respectively, and differed in cluster symptom constitution. Limitations: Patients selected themselves for study inclusion and were paid for their participation. This could have affected random selection. Lastly, we used the current time definitions of acute pain versus chronic pain (90 days) to separate our patients into these groups. Currently, no consensus exists regarding the optimal time duration to divide acute from chronic. Conclusions: APPs and CPPs are characterized by symptom comorbidities that form clusters. In CPPs, cluster number and cluster symptom makeup are affected by pain level. This has implications for clinical practice and future research. Key words: Comorbidity, somatic symptoms, comorbid symptoms, chronic pain patients, acute pain patients, community patients without pain, clusters, symptom clusters

scholarly journals Pain, Stress and Anxiety of Chronic Pain Patients Prior to, During and After Political Turmoil in Thailand

2018 ◽  
Vol 36 (4) ◽  
pp. 291
Author(s):  
Sasikaan Nimmaanrat
Keyword(s):  
Chronic Pain ◽  
Pain Score ◽  
Pain Clinic ◽  
P Value ◽  
Military Dictatorship ◽  
Chronic Pain Patients ◽  
The Mean ◽  
Stress Score ◽  
Political Turmoil ◽  
Pain Patients

Objective: Thailand was plagued with serious political turmoil for many years. We would like to know whether this turmoil has had an impact on our chronic pain patients in terms of intensity of pain, stress and anxiety, as well as daily living and sleep.Material and Methods: Patients with at least 3 months of pain prior to 31 October 2013 (the date that the demonstrations started) were enrolled in this study. The data were collected from the patients who attended our pain clinic from December 2014 to May 2015. The patients were asked to complete a questionnaire on their severity of pain, stress and anxiety for the 3 different stages: prior to the demonstrations (period 1), during the demonstrations (period 2) and under military dictatorship or after the demonstrations (period 3).Results: There were 120 patients, 49 males (40.8%) and 71 females (59.2%). The mean age was 56.3±15.8 years old (range 18-88). The majority were Buddhist (108 patients, 90.0%) while 11 patients (9.2%) were Muslim and 1 patient (0.8%) was Christian. The mean duration of pain prior to the beginning of the demonstrations was 62.8 months (range 3-324 months). Regarding the pain score, the mean maximum pain score was significantly different between periods 1 (8), 2 (7.7) and 3 (6.8) (p-value<0.001). Regarding the anxiety score, the mean maximum anxiety score was significantly different between periods 1 (3.8), 2 (4.8) and 3 (2.9) (p-value=0.03). Regarding the stress score, the mean maximum stress score was significantly different between periods 1 (3.8), 2 (4.4) and 3 (2.8) (p-value=0.02). Using multiple logistic regression analysis, no factors (gender, age, religious, duration of pain and levels of anxiety and stress) were found to have contributed to the reduction of pain intensity.Conclusion: The demonstrations during the political turmoil did not increase the severity of pain but led to higher levels of stress and anxiety. On the other hand, under the military dictatorship, lower pain scores as well as stress and anxiety levels in chronic pain patients attending our pain clinic have been found.

scholarly journals An Objective Pain Score for Chronic Pain Clinic Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Agnes K. Pace ◽  
Melanio Bruceta ◽  
John Donovan ◽  
Sonia J. Vaida ◽  
Jill M. Eckert
Keyword(s):  
Chronic Pain ◽  
Construct Validity ◽  
Concurrent Validity ◽  
Interrater Reliability ◽  
Pain Scale ◽  
Pain Clinic ◽  
Positive Correlation ◽  
Pain Scales ◽  
Chronic Pain Patients ◽  
Pain Patients

Objectives. Although numerous studies have looked at the numeric rating scale (NRS) in chronic pain patients and several studies have evaluated objective pain scales, no known studies have assessed an objective pain scale for use in the evaluation of adult chronic pain patients in the outpatient setting. Subjective scales require patients to convert a subjective feeling into a quantitative number. Meanwhile, objective pain scales utilize, for the most part, the patient’s behavioral component as observed by the provider in addition to the patient’s subjective perception of pain. This study aims to examine the reliability and validity of an objective Chronic Pain Behavioral Pain Scale for Adults (CBPS) as compared to the traditional NRS. Methods. In this cross-sectional study, patients were assessed before and after an interventional pain procedure by a researcher and a nurse using the CBPS and the NRS. Interrater reliability, concurrent validity, and construct validity were analyzed. Results. Interrater reliability revealed a fair-good agreement between the nurse’s and researcher’s CBPS scores, weighted kappa values of 0.59 and 0.65, preprocedure and postprocedure, respectively. Concurrent validity showed low positive correlation for the preprocedure measurements, 0.34 (95% CI 0.16–0.50) and 0.47 (95% CI 0.31–0.61), and moderate positive correlation for the postprocedure measurements, 0.68 (95% CI 0.56–0.77) and 0.67 (95% CI 0.55–0.77), for the nurses and researchers, respectively. Construct validity demonstrated an equally average significant reduction in pain from preprocedure to postprocedure, CBPS and NRS median (IQR) scores preprocedure (4 (2–6) and 6 (4–8)) and postprocedure (1 (0–2) and 3 (0–5)), p < 0.001 . Discussion. The CBPS has been shown to have interrater reliability, concurrent validity, and construct validity. However, further testing is needed to show its potential benefits over other pain scales and its effectiveness in treating patients with chronic pain over a long-term. This study was registered with ClinicalTrial.gov with National Clinical Trial Number NCT02882971.

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