Assessment of cancer pain

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19500-19500
Author(s):  
A. F. Dugas ◽  
B. A. Murphy ◽  
N. Wells ◽  
M. S. Dietrich ◽  
K. Dwyer
Keyword(s):  
Pain Assessment ◽  
Pain Control ◽  
Severe Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Mean Value ◽  
Emotional Reactions ◽  
Numerical Rating ◽  
The Mean ◽  
Definition Of

19500 Background: This study investigates: 1) The concordance between patients and staffs’ standard use of the numerical rating scale (NRS) for pain, in which 1–4 is mild pain, 5–6 is moderate and 7 and above is severe; 2) The relative importance of functional impairment secondary to pain in patients’ pain ratings. Methods: Patients with cancer and current or previous pain (N=178) were asked to complete a fifteen minute interview with open-ended questions about their perception of pain. Results: When asked to define mild, moderate and severe pain according to the NRS, 65% of patients gave numbers that did not meet standard definitions as noted above. When asked to define mild, moderate and severe pain in general, 38% differentiated severity of pain based on its impact on their ability to fulfill activities of daily living (ADLs) and 39% differentiated it based on their emotional reactions. When asked to define tolerable pain, 28% described it in terms of its impact on ADLs, while 30% described it in terms of the NRS. For those patients who used a NRS, the mean value for tolerable pain was 4.9 (range 2–8) and the mean value for intolerable pain was 8.1 (range 5–10). 26% of patients defined satisfactory pain control based its impact on ADLs while only 2% defined it according to a NRS. 68% of patients reported that pain interfered with their ADLs, however only 33% reported that pain medication interfered. Conclusions: There is discordance between the standard definition of the NRS and patient perceptions of it, suggesting it should be supplemented by other types of pain assessment. Based on NRS, patients tolerate higher levels of pain than expected. Patient satisfaction with pain control is more dependent upon ability to complete ADLs than on a numerical rating of pain. Therefore, patients’ ability to function at an acceptable level should be part of the standard pain assessment. No significant financial relationships to disclose.

scholarly journals Individual Differences and Similarities in the Judgement of Facial Pain: A Mixed Method Study

2020 ◽  
Vol 10 (4) ◽  
pp. 1186-1194
Author(s):  
Sheila Glenn ◽  
Helen Poole ◽  
Paula Oulton
Keyword(s):  
Individual Differences ◽  
Undergraduate Students ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Catastrophizing ◽  
Sensory Sensitivity ◽  
Facial Cues ◽  
Numerical Rating

Accurate assessment of pain by health-care professionals is essential to ensure optimal management of pain. An under-researched area is whether personality characteristics affect perception of pain in others. The aims were (a) to determine whether individual differences are associated with participants’ ability to assess pain, and (b) to determine facial cues used in the assessment of pain. One hundred and twenty-eight undergraduate students participated. They completed questionnaire assessments of empathy, pain catastrophizing, sensory sensitivity and emotional intelligence. They then viewed and rated four adult facial images (no, medium, and high pain—12 images total) using a 0–10 numerical rating scale, and noted the reasons for their ratings. (a) Empathy was the only characteristic associated with accuracy of pain assessment. (b) Descriptions of eyes and mouth, and eyes alone were most commonly associated with assessment accuracy. This was the case despite variations in the expression of pain in the four faces. Future studies could evaluate the effect on accuracy of pain assessment of (a) training empathic skills for pain assessment, and (b) emphasizing attention to the eyes, and eyes and mouth.

Xenon analgesia in children with extensive wounds

2021 ◽  
pp. 52-57
Author(s):  
V. G. Bagaev ◽  
N. G. Rauschenbach ◽  
V. A. Mitish ◽  
P. V. Medinsky ◽  
V. G. Amcheslavsky ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Local Treatment ◽  
Mean Value ◽  
Wound Dressings ◽  
Severe Injuries ◽  
Relieve Pain ◽  
Xenon Concentration ◽  
Numerical Rating ◽  
Ramsay Scale

Purpose. To assess the effectiveness of sub-narcotic concentrations of xenon in the local treatment of extensive wounds in children with severe injuries.Material and methods. 14 patients (average age 9.3 ± 4.0 years) with extensive wounds were taken into the trial. 67 dressings in them were done with 30 % xenon and oxygen. Pain intensity was assessed by the numerical rating scale of pain (NRSp) (1–10 points); sedation depth – by Ramsay scale (1–6 points) and BIS index.Results. Inhalations of 30 % xenon with oxygen during wound dressings reduced the intensity of pain from Me 3.67 (1.2; 6.0) to Me 2.0 (1.0; 3.3) points by NRSp scale (p < 0.05); after sedanalgesia, it increased again to Me 3.0 (1.0; 5.3). Analgesia with 30 % xenon was effective in 55 (82.0 %) dressings; in 8 (11.9 %) patients with trauma, xenon concentration was increased to 50 %, and in 4 (5.9 %) cases 50 % xenon was added with Fentanyl 1–2 mcg/kg. The depth of sedation assessed by the Ramsay scale decreased (p < 0.05) from 6.0 (5.6; 6.0) to 3.1 (2.2; 4.5) points; after sedanalgesia it increased to Me 5.0 (4.5; 5.4) points. At the same time, the mean value of BIS index decreased (p < 0.05) from 97.5 ± 1.5 to 86.5 ± 5.0 U; after dressing, it rapidly increased to 93.0 ± 2.1 U. During dressings, 82 % of children were calm, had contact with a doctor. Afterwards, their sleep was restored, their mood improved.Conclusion. Sedanalgesia with xenon in sub-narcotic concentrations is an effective technique to relieve pain during treatment of extensive wounds in children.

scholarly journals Acute Pain Assessment Inadequacy in the Emergency Department: Patients’ Perspective

2022 ◽  
Vol 9 ◽  
pp. 237437352110496
Author(s):  
Jenni Hämäläinen ◽  
Tarja Kvist ◽  
Päivi Kankkunen
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Numerical Rating ◽  
Emergency Department Patients ◽  
Pain At Rest ◽  
Patients Perspective

For many patients, acute pain is a common cause to seek treatment in an Emergency Department (ED). An inadequate assessment could cause inappropriate pain management. The aim of this study was to describe and explain patients’ perceptions of acute pain assessment in the Emergency Department. The data were collected from ED patients (n = 114). Patients reported that nurses were asking about intensity of pain at rest, but only 52% during movement. According to the patients, the most common tools to assess acute pain were the verbal rating scale (VRS; 54% of patients), numerical rating scale (NRS; 28% of patients), and visual analogue scale (VAS; 9.7% of patients). Over twenty per cent of patients stated that ED nurses did not ask about the intensity of pain after analgesic administration. Twenty-four per cent of the patients were not pleased with nursing pain assessment in the ED. The assessment of acute pain is still inadequate in the ED. Therefore, ED nurses need to be more attentive to systematic acute pain management of patients in the ED.

scholarly journals The association of pain and stiffness with fatigue in incident polymyalgia rheumatica: baseline results from the polymyalgia rheumatica cohort study

2019 ◽  
Vol 20 ◽  
Author(s):  
J.A. Prior ◽  
S. Muller ◽  
T. Helliwell ◽  
S.L. Hider ◽  
K. Barraclough ◽  
...  
Keyword(s):  
General Practice ◽  
Cohort Study ◽  
Polymyalgia Rheumatica ◽  
Symptom Severity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Newly Diagnosed ◽  
Fatigue Score ◽  
Numerical Rating ◽  
The Mean

AbstractWe aimed to examine the association between pain, stiffness and fatigue in newly diagnosed polymyalgia rheumatica (PMR) patients using baseline data from a prospective cohort study. Fatigue is a known, but often ignored symptom of PMR. Newly diagnosed PMR patients were recruited from general practice and mailed a baseline questionnaire. This included a numerical rating scale for pain and stiffness severity, manikins identifying locations of pain and stiffness and the FACIT-Fatigue questionnaire. A total of 652 PMR patients responded (88.5%). The mean age of responders was 72.6 years (SD 9.0) and the majority were female (62.0%). Manikin data demonstrated that bilateral shoulder and hip pain and stiffness were common. The mean fatigue score (FACIT) was 33.9 (SD 12.4). Adjusted regression analysis demonstrated that a higher number of pain sites (23–44 sites) and higher pain and stiffness severity were associated with greater levels of fatigue. In newly diagnosed PMR patients, fatigue was associated with PMR symptom severity.

Clinical and radiological outcomes of the Ivory arthroplasty for trapeziometacarpal joint osteoarthritis with a minimum of 5 years of follow-up: a prospective single-centre cohort study

2013 ◽  
Vol 38 (8) ◽  
pp. 866-874 ◽  
Author(s):  
J. F. Goubau ◽  
C. K. Goorens ◽  
P. Van Hoonacker ◽  
B. Berghs ◽  
D. Kerckhove ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Survival Rates ◽  
Trapeziometacarpal Joint ◽  
Term Survival ◽  
Numerical Rating ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
The Mean

We present the results of a 5 year prospective follow-up study on the functional outcome after total replacement of the trapeziometacarpal joint with the Ivory prosthesis (Memometal, Stryker Corporate, Kalamazoo, Michigan, USA) in 22 patients. The female to male ratio was 21:1 and the mean age was 66 (range 54–78) years. The mean follow-up period was 67 (range 60–77) months after operation. Patient satisfaction was high. The mobility of the operated thumb was restored to a range of motion comparable to the contralateral thumb. Key pinch and grip strength improved by 13% and 31%, respectively. Overall function, according to Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, improved by 59%. Pain decreased by 85% according to the numerical rating scale. Radiological evaluation revealed no loosening of the implant after 5 years except in one patient who required revision due to polythene wear with secondary joint instability. Another patient had asymptomatic polythene wear that required no revision but remains in follow-up. The 5 year overall survival of the prosthesis was 95%. These medium-term results suggest that the Ivory arthroplasty is a reliable option for treating advanced trapeziometacarpal arthritis, because it appears to give a very good functional outcome and has the potential for long-term survival rates.

Prevalence of Persistent Pain after Total Knee Arthroplasty and the Impact of Neuropathic Pain

2018 ◽  
Vol 32 (10) ◽  
pp. 1020-1023 ◽  
Author(s):  
Masahiro Hasegawa ◽  
Shine Tone ◽  
Yohei Naito ◽  
Hiroki Wakabayashi ◽  
Akihiro Sudo
Keyword(s):  
Total Knee Arthroplasty ◽  
Neuropathic Pain ◽  
Knee Arthroplasty ◽  
Severe Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Number Of Patients ◽  
Numerical Rating ◽  
Total Knee ◽  
The Impact

AbstractThe present study aimed to define the prevalence of pain persisting after total knee arthroplasty (TKA) and determine the impact of neuropathic pain. Knee pain after TKA was evaluated in 154 patients (222 knees with osteoarthritis) using a numerical rating scale (NRS) and followed up for a mean of 4.7 years. The patients were classified according to whether they had no or mild pain (NRS ≤ 3), or moderate-to-severe pain (NRS > 3), and then assigned to groups with nociceptive, unclear, or neuropathic pain based on responses to painDETECT questionnaires. Risk factors for these types of pain were determined. The ratio of patients with moderate-to-severe pain was 28% (62 knees). Thirteen patients (21 knees; 9%) experienced unclear pain. Patients with moderate-to-severe or unclear pain had malalignment and lower Knee Society knee scores. In conclusion, a significant number of patients experienced moderate-to-severe and unclear pain after TKA. Moderate-to-severe pain was associated with unclear pain.

scholarly journals The risks of physicians’ conformism: reflections from the opioid overflow

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Luisa Cortellazzo Wiel ◽  
Giorgio Cozzi ◽  
Egidio Barbi
Keyword(s):  
Severe Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Good Clinical Practice ◽  
Pain Evaluation ◽  
Complex Process ◽  
The Us ◽  
Numerical Rating ◽  
Chronic Severe Pain ◽  
New Evidence

AbstractOpioid-related mortality in adolescents is spreading in the US, with prescription opioids playing a crucial role in the development of addiction. We traced back to the process leading to the so called “opioid overflow”, trying to identify any modifiable attitude.Since the late 1990s, pain was labelled as the “fifth vital sign” and its proper management was prompted, encouraging the use of opioids for any pain scored at a Numerical Rating Scale (NRS) of 7 or higher. This assumption has some remarkable limitations. NRS is a proxy of pain severity in children, and pain measurement should be strengthened by a more comprehensive pain evaluation. Moreover, while remaining a fundamental therapeutic right of patients suffering postoperative or chronic severe pain, opioids show no evidence of superiority respect to non-opioid regimens in the management of pain from several acute conditions.Italy, as other European countries, is often reluctant to the use of opioids, even when highly recommendable, missing the opportunity of properly treating those selected patients with severe pain. Both attitudes can be viewed as the result of an extreme simplification of the complex process of pain evaluation and treatment, by means of a ‘one-size-fits-all’ approach.This highlights the need for a systematic and patient-tailored attitude to children in pain, avoiding applying guidelines without question. Good clinical practice must rely on guidelines, which, however, as often based on partial and insufficient data, can be questioned by emerging new evidence, and should not substitute our rational thinking, and capability to understand each patient, avoiding excessive conformism.

scholarly journals Strategy to prevent nerve injury and deep vein thrombosis in radiofrequency segmental thermal ablation of the saphenous veins using a new objective pain scale

2021 ◽  
pp. 026835552110105
Author(s):  
Kenji Yamamoto ◽  
Senri Miwa ◽  
Tomoyuki Yamada ◽  
Shuji Setozaki ◽  
Mamoru Hamuro ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Nerve Injury ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Scale ◽  
Vein Thrombosis ◽  
Numerical Rating ◽  
Endovenous Ablation ◽  
The Mean ◽  
Deep Vein

Objective We evaluated the benefit of local anesthesia including tumescent anesthesia and active walking soon after surgery in preventing nerve injury and deep vein thrombosis caused during endovenous ablation. Methods Endovenous ablation was performed in 1334 consecutive patients. Varicectomy was performed using the stab avulsion technique. After surgery, patients were encouraged to walk 100–200 m inside the ward for 3–5 times/h. The pain was evaluated objectively using the Okamura pain scale and subjectively using the numerical rating scale. Results Stab avulsion was performed at 11.8 ± 8.0 sites and the mean operative time was 33.9 ± 15.2 min. The mean Okamura pain scale and numerical rating scale scores were 1.6 ± 1.3 and 3.0 ± 2.0, respectively. Deep vein thrombosis and pulmonary embolism were absent. The incidence of nerve injury was 0.3%. Conclusions Endovenous ablation should be performed with the patients under local anesthesia to prevent nerve injury and deep vein thrombosis.

scholarly journals Cat Stretch Exercise sebagai Salah Satu Solusi Mengatasi Dismenore pada Remaja Putri

2020 ◽  
Vol 1 (1) ◽  
pp. 50-57
Author(s):  
Yunita Wulandari ◽  
Ika Subekti Wulandari ◽  
Atiek Murharyati
Keyword(s):  
Community Service ◽  
Severe Pain ◽  
Rating Scale ◽  
Control Method ◽  
Numerical Rating Scale ◽  
Pain Scale ◽  
Lower Abdomen ◽  
Before And After ◽  
Post Test ◽  
Numerical Rating

Background: Dysmenorrhea is a result of menstruation. Dysmenorrhea can cause a variety of complaints in young women such as irregular pain, severe pain and cramps in the lower abdomen that will spread to the back of the back, legs, groin. Cat Stretch Exercise is one of the interventions that is considered to reduce dysmenorrhea pain. The purpose of this study was to determine changes in pain levels in Pondok Imam Bukhari students who were given Cat Stretch Exercise. Methods: The study design used a quasi-two-group pre-test and post-test without control method. Pain measurement with a Numerical Rating Scale (NRS) to assess the level of pain before and after the Cat Stretch Exercise exercise. Respondents in the community service were 31 students who experienced dismenore. Results: Obtained decreased respondents' pain scale from moderate to mild pain. Conclusion: CSE interventions are recommended as one of the non-pharmacological steps to deal with the pain of dysmenorrhea.

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