The Effect of the Treatment at a Pain Clinic on the Patients’ Assessment of Their Pain Intensity and the Incidence of Mental Disorders in the form of Anxiety, Depression, and Aggression

The aim of the study was to analyze the effect of the treatment given to patients in a pain clinic on their assessment of pain intensity and the incidence of emotional disturbances in the form of anxiety, depression, and aggression. The study was conducted from January 2014 to April 2018 among patients under the care of two Warsaw pain clinics. The study tools were the Hospital Anxiety and Depression Scale—Modified Version (HADS-M) and the Numerical Rating Scale (NRS). The project enrolled 325 patients, with women comprising 60.62% of patients, and the age bracked of 65–79 years comprising 39.38% of patient. The major reasons for attending the pain clinic were osteoarticular pain (44.92%) and neuropathic pain (42.77%). The therapy applied lowered the patients’ pain intensity (4.98 vs. 3.83), anxiety (8.71 vs. 8.12), aggression (3.30 vs. 3.08), and the overall HADS-M score (18.93 vs. 17.90), which shows that the treatment of both the pain symptoms and the associated emotional disturbances in the form of anxiety and aggression was effective. Sex is a factor affecting pain intensity. The level of mental disorders was influenced by the sex and age of the patients and how long they had been treated in the pain clinics.

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Analysis of Anxiety, Depression and Aggression in Patients Attending Pain Clinics

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15122898 ◽

2018 ◽

Vol 15 (12) ◽

pp. 2898 ◽

Cited By ~ 3

Author(s):

Dariusz Kosson ◽

Małgorzata Malec-Milewska ◽

Robert Gałązkowski ◽

Patryk Rzońca

Keyword(s):

Pain Intensity ◽

Rating Scale ◽

Numerical Rating Scale ◽

Depression Scale ◽

Emotional Disturbances ◽

Pain Clinic ◽

Pain Clinics ◽

Numerical Rating ◽

Anxiety Depression ◽

The City

The aim of the study was to measure the frequency of such emotional disturbances as anxiety, depression and aggression among patients treated in a pain clinic, as well as assess the factors contributing to such disorders. Research was conducted from January 2014 to April 2018 and involved patients treated in two pain clinics in the city of Warsaw, Poland. The study used the Hospital Anxiety and Depression Scale—Modified Version (HADS-M) and the Numerical Rating Scale (NSR). 1025 patients were recruited. The main reasons for their attending the pain clinic were osteoarticular pain (43.61%) and neuropathic pain (41.56%). Emotional disturbances in the form of anxiety were diagnosed in 32.39% of all the patients, depression in 17.85%, and aggression in 46.15%. The factors determining the level of anxiety in the study group were: sex, age, pain intensity and the lack of pharmacological treatment. Depression was determined by sex, pain intensity and the time of treatment in the clinic, while aggression by age and pain intensity.

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Assessing Pain Intensity in Children with Chronic Pain: Convergent and Discriminant Validity of The 0 To 10 Numerical Rating Scale in Clinical Practice

Pain Research and Management ◽

10.1155/2014/856513 ◽

2014 ◽

Vol 19 (3) ◽

pp. 141-148 ◽

Cited By ~ 29

Author(s):

Danielle Ruskin ◽

Chitra Lalloo ◽

Khushnuma Amaria ◽

Jennifer N Stinson ◽

Erika Kewley ◽

...

Keyword(s):

Chronic Pain ◽

Clinical Practice ◽

Pain Intensity ◽

Discriminant Validity ◽

Rating Scale ◽

Numerical Rating Scale ◽

Pain Clinic ◽

Small Range ◽

Convergent And Discriminant Validity ◽

Numerical Rating

BACKGROUND: In clinical practice, children are often asked to rate their pain intensity on a simple 0 to 10 numerical rating scale (NRS). Although the NRS is a well-established measure for adults, no study has yet evaluated its validity for children with chronic pain.OBJECTIVES: To examine the convergent and discriminant validity of the NRS as it is used within regular clinical practice to document pain intensity for children with chronic pain. Interchangeability between the NRS and an analogue pain measure was also assessed.METHODS: A cohort of 143 children (mean [± SD] age 14.1±2.4 years; 72% female) rated their pain intensity (current, usual, lowest and strongest levels) on a verbally administered 0 to 10 NRS during their first appointment at a specialized pain clinic. In a separate session that occurred either immediately before or after their appointment, children also rated their pain using the validated 0 to 10 coloured analogue scale (CAS).RESULTS: NRS ratings met a priori criteria for convergent validity (r>0.3 to 0.5), correlating with CAS ratings at all four pain levels (r=0.58 to 0.68; all P<0.001). NRS for usual pain intensity differed significantly from an affective pain rating, as hypothesized (Z=2.84; P=0.005), demonstrating discriminant validity. The absolute differences between NRS and CAS pain scores were small (range 0.98±1.4 to 1.75±1.9); however, the two scales were not interchangeable.CONCLUSIONS: The present study provides preliminary evidence that the NRS is a valid measure for assessing pain intensity in children with chronic pain.

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Effectiveness of Neck Myofascial Release Techniques and Exercise Therapy on Pain Intensity and Disability in Patients with Chronic Tension-Type Headache

Global Journal of Health Science ◽

10.5539/gjhs.v9n6p47 ◽

2016 ◽

Vol 9 (6) ◽

pp. 47

Author(s):

Mohammad Hosseinifar ◽

Razieh Bazghandi ◽

Zahra Azimi ◽

Bahareh Khodadadi Bohlouli

Keyword(s):

Pain Intensity ◽

Exercise Therapy ◽

Rating Scale ◽

Numerical Rating Scale ◽

Tension Type Headache ◽

Control Group ◽

Myofascial Release ◽

Headache Intensity ◽

Headache Disability ◽

Type Headache

PURPOSE: Tension type headache (TTH) is one of the most prevalent types of headache. TTH is classified as episodic if it occurs on less than 15 days a month and as chronic if it occurs more often. Tension, anxiety and depression are some etiological factors for TTH which leads to work efficiency reduction. Today the interest in non-pharmacological methods is increasing; massage is one of these approaches which has no side effects. Aim of this study was to investigate the effects of neck Myofascial Release (MFR) techniques and exercise therapy on pain intensity and disability in patients with chronic tension-type headache.METHODS: This randomized clinical trial study was investigated on 30 females suffering from TTH. Participants were randomly assigned into two equal groups (n=15). The MFR group received neck MFR massage and exercise therapy four times a week for 3 weeks, each session lasting 45 minutes. Control group had no intervention. Outcomes were headache intensity and disability measured by numerical rating scale (NRS) and headache disability index (HDI), respectively. Data was analysed through independent and pair t-test.RESULTS: Between group comparison showed significant improvement of headache intensity and disability rate in MFR group (p<0.05) than control group (p=0.000).DISCUSSION: This study provides evidences that MFR technique and exercise therapy have significant effect on patients with TTH.

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How to obtain the biopsychosocial record in multidisciplinary pain clinic? An action research study

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2017.04.051 ◽

2017 ◽

Vol 16 (1) ◽

pp. 182-182

Author(s):

L.B. Sejling ◽

L. Svensson ◽

P.F. Jensen ◽

W.Z. Pawlak

Keyword(s):

Action Research ◽

Pain Intensity ◽

Rating Scale ◽

Pain Treatment ◽

Demographic Data ◽

Multidisciplinary Treatment ◽

Pain Clinic ◽

Treatment Goals ◽

Area Of Interest ◽

Walking Activity

Abstract Background Patients with complicated chronic non-malignant pain (CCNMP) should be referred to the multidisciplinary treatment based on the biopsychosocial pain model. This is not a trivial task to obtain the biopsychosocial record (BPSR) during the first visit in multidisciplinary pain center – some important data can be missing, but it is difficult to choose the right questions. Purpose To find the optimal method for obtaining of BPSR in patients with CCNMP. Methods The action research methodology is used. First, the literature search was done. Second, the meetings between therapists were hold. Third, the patients are asked about their experiences with obtaining of BPSR. Results The following area of interest were identified: (1) patient’s demographic data, (2) lifestyle factors, (3) previous diseases, (4) concurrent diseases, (5) previous pain treatments, (6) pain intensity and effect of the actual pain treatment, (7) general activity, (8) mood, (9) walking activity, (10) work ability, (11) home activities, (12) relations with other people, (13) sleep, (14) enjoyment of life, (15) patients expectations from treatment, and (16) treatment goals. Patients are asked about those variables. Either Visual Analogue Scale or Numeric Rating Scale is used for assessment of pain intensity and pain influence on variables (7) to (14). First, data about variables (1) to (6) are collected by the physician. Next, data about variables (7) to (15) are gathered under interview with the nurse. Last, the physician and the nurse keep the meeting on treatment goals and treatment course. Up to date (February 2017), 8 patients were asked about their experience with obtaining of BPSR. All but one patient were very satisfied. Conclusions The method presented above seems to be promising approach to obtaining of BPSJ in patients with CCNMP. The study is ongoing and updated results will be presented at the conference.

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Effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20170165 ◽

2017 ◽

Vol 5 (2) ◽

pp. 631

Author(s):

Zahra Abbas Ali Madadi ◽

Jalil Azimian ◽

Farzaneh Falahatpishe ◽

Mahmoud Alipour Heidari

Keyword(s):

Pain Intensity ◽

Arteriovenous Fistula ◽

Rating Scale ◽

Control Method ◽

Numerical Rating Scale ◽

Simple Random Sampling ◽

Hemodialysis Patients ◽

Numerical Rating ◽

Rating Scale Data ◽

Frequent Hemodialysis

Background: Pain and stress of hemodialysis are experienced by more than 50% of patients who are suffering from renal disease; hence decreasing a part of these adverse effects can be effective on individual’s long term coping with hemodialysis. The current study was done to determine the effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients.Methods: This clinical trial was conducted on 31 hemodialysis patients in 2014. The patients were selected by simple random sampling method and placed in one group. First, the pain intensity of all patients was measured in the six frequent hemodialysis sessions without any intervention (control method). After two weeks, the intervention of warm footbath with vibration was done on all patients and the pain intensity was measured for six frequent hemodialysis sessions (intervention method). The patients were received 40±2 °C footbath with vibration by foot massage spa machine for ten minutes; then, fistula needles were placed and the pain intensity was assessed by using a numerical rating scale. Data were analyzed by ANOVA and T test.Results: The study group had contained 20 males (64.5%), 11 females (35.5%), with an average age of 44.16±14.85 and a range of 18 to 65 years old, which shows that the pain intensity of the warm footbath with vibration method was lower than the control method (P< 0.05).Conclusions: Warm footbath with vibration can be used as an effective palliative method to reduce pain of hemodialysis patients.

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The antistress effect of Xenon in subnarcotic concentrations in children with severe injuries

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2020-24-4-249-255 ◽

2020 ◽

Vol 24 (4) ◽

pp. 249-255

Author(s):

Vladimir G. Bagaev ◽

V. A. Mitish ◽

T. C. Sabinina ◽

O. C. Melnichuk ◽

P. V. Medinsky ◽

...

Keyword(s):

Pain Intensity ◽

Rating Scale ◽

Acute Stress ◽

Numerical Rating Scale ◽

Terrorist Attack ◽

Stress Hormones ◽

Pain Syndrome ◽

Stress Effect ◽

Drug Induced ◽

Severe Injuries

Introduction. In the present trial, the authors studied anti-stress properties of subnarcotic concentrations of gas Xenon (Xe) which is used for treating children with severe traumas. Purpose. To study anti-stress properties of subnarcotic concentrations of gas Xenon (Xe) which is used for treating children with severe injuries. Material and methods. 10 children, aged 13 ± 3 years, with severe trauma were taken into the study: 6 girls with mine-explosive injuries ( a terrorist attack in Kerch in 2018), 3 boys with multiple dog bites and one patient after a traffic accident. To treat them, 20-30% Xe with O2 was used. A session lasted for 20 minutes; the course included from 5 to 12 sessions. Device KTK-01 (LLC “KseMed”, Russia) was used. Pain intensity was assessed with the numerical rating scale (NRS) , sedative effect - with BIS index and Ramsey sedation scale. Patients’ blood was also examined for the level of somatotropic hormone (STH), cortisol (Co) and insulin. Results. Indications for Xe therapy in children were: persistent pain syndrome (PS) and acute stress disorder (ASD). Patients fell asleep (drug-induced sleep) under 20-30% Xe concentration in the respiratory mixture. The average values of BIS index decreased from 95.5 ± 2.5 U to 86.5 ± 5.0 U (p <0.05), and of Ramsay scale - from 5.5 ± 0.5 to 2.7 ± 1.2 points (p <0.05). Pain intensity by NRS decreased from 4.1 ± 1.8 to 1.1 ± 0.4 points (p <0.05). The level of stress hormones during Xe session went down: STH- from 4.8 ± 0.9 ng / ml to 1.9 ± 0.5 ng / ml (p <0.001); Ko - from 375.5 ± 23.6 nmol / L to 303.2 ± 20.7 nmol / L (p <0.0001); insulin - from 19.9 ± 3.6 pmol / L to 11.7 ± 2.7 pmol / L (p <0.001). To restore sleep, 2 - 3 sessions were needed; to relief PS - 5 sessions, to refuse of painkillers in phantom pains - 12 sessions. Conclusion. 20-30% Xe with oxygen therapy has a pronounced analgesic, sedative and anti-stress effect in children with severe injuries.

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Traditional Acupuncture and Laser Acupuncture in Chronic Nonspecific Neck Pain: Study Protocol for a Randomized Controlled Trial

10.21203/rs.3.rs-853159/v1 ◽

2021 ◽

Author(s):

RAFAELA PERON ◽

Érika Patrícia Rampazo ◽

Richard Eloin Liebano

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Rating Scale ◽

Acupuncture Treatment ◽

Numerical Rating Scale ◽

Controlled Trial ◽

Pressure Pain Threshold ◽

Pain Modulation ◽

Laser Acupuncture ◽

Acupuncture Points

Abstract Background: Nonspecific neck pain is a multifactorial and very common condition in adult individuals. No reports were found in the literature comparing the effectiveness of Traditional Acupuncture (TA) and Laser Acupuncture (LA) in cases of chronic nonspecific neck pain. Therefore, the aim of the present study is to investigate the effectiveness of TA and LA therapies in individuals with chronic nonspecific neck pain.Methods/design: This study will be a controlled and randomized clinical trial. A total of 60 individuals will be randomized into two groups (30 each). The TA group will receive the acupuncture treatment using needles, while the LA group will receive the laser acupuncture treatment. The acupuncture points (Tianzhu, Fengchi, Jianjing, and Jianzhongshu) will be stimulated bilaterally with needles or laser. The primary outcome will be pain intensity, determined using the numerical rating scale. The secondary outcomes will be pressure pain threshold, temporal summation of pain, conditioned pain modulation, use of analgesic drugs after treatment, and the global perceived effect scale. The assessments will be performed immediately before and after treatment. At the follow-up, 1 months after the end of the treatments, evaluation will be made of the pain intensity and the global perceived effect. Statistical analysis of the data obtained will consider a significance level of p < 0.05.Discussion: This study will provide evidence concerning the effects of LA treatment, in comparison to TA, leading to benefits for individuals suffering from chronic nonspecific neck pain.Trial registration: RBR-7vbw5gd (Brazilian Registry of Clinical Trials - ReBEC)

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What is the clinical relevance of the Numerical rating scale for pain?

10.1093/med/9780198834359.003.0059 ◽

2018 ◽

Author(s):

Felicia Cox

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Rating Scale ◽

Numerical Rating Scale ◽

Clinical Importance ◽

Patient Global Impression ◽

Numerical Rating ◽

Group A ◽

Clinically Significant ◽

Global Impression Of Change

The landmark paper discussed in this chapter is ‘Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale’, published by Farrar et al. in 2001. The numerical rating scale is now the standard instrument used in chronic pain studies to measure pain intensity. Farrar et al. determined the changes in pain intensity that were clinically significant for studies of chronic pain while measuring the patient’s global impression of change. The paper used pooled data from ten recent studies of pregabalin in 2,724 subjects. The authors reported a consistent relationship between pain intensity and patient global impression of change, regardless of study, disease type, age, sex, study result, or treatment group. A reduction of approximately two points on the numerical rating scale, or of 30% in the global impression of change of pain intensity, represented a clinically important difference.

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Perioperative patient-controlled regional analgesia versus patient-controlled intravenous analgesia for patients with critical limb ischaemia: a study protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-037879 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037879

Author(s):

Si Chen ◽

Zhonghuang Xu ◽

Hongju Liu ◽

Yuelun Zhang ◽

Jiao Zhang ◽

...

Keyword(s):

Rating Scale ◽

Numerical Rating Scale ◽

Depression Scale ◽

Critical Limb Ischaemia ◽

Limb Ischaemia ◽

Regional Analgesia ◽

Transcutaneous Oxygen ◽

Group I ◽

Intravenous Analgesia ◽

T1 And T2

IntroductionBoth regional analgesia and intravenous analgesia are frequently used perioperatively for patients with critical limb ischaemia (CLI). Nevertheless, the comparison of perioperative effect of regional and intravenous analgesia has not yet been thoroughly illustrated. This study will comprehensively compare patient-controlled regional analgesia (PCRA) and patient-controlled intravenous analgesia (PCIA) as two different perioperative analgesia approaches for patients with CLI. It investigates their effects on analgesia, reperfusion and the quality of recovery perioperatively, also aims to provide clinical evidence to those non-surgical patients with non-reconstructable arteries.Methods and analysisThis trial is a randomised, single-centre, open-label, parallel trial with target sample size of 52 in total. Eligible participants will be randomly allocated to the PCRA group (group R) or the PCIA group (group I) after admission. Participants in group R will receive ultrasound-guided subgluteal sciatic catheterisation, followed by continuous PCRA infusion (0.2% ropivacaine 15 mL as loading dose, 8 mL/hour as background with a patient-controlled bolus of 6 mL). Participants in group I will receive PCIA (morphine is given in boluses of 1 mg as needed, background infusion at 1 mg/hour). Data will be collected at baseline (T0), 2 hours before revascularisation treatment (T1) and 2 hours before discharge (T2). The primary outcomes include the Numerical Rating Scale pain score at T1 and T2. The secondary outcomes include the perioperative transcutaneous oxygen pressure, the Tissue Haemoglobin Index, Hospital Anxiety and Depression Scale at T1 and T2; the Patient Global Impression of Change and patient satisfaction at T1 and T2; the perioperative cumulative morphine consumption, the length of postoperative hospital stay and adverse events.Ethics and disseminationThis study received authorisation from the Institutional Review Board of Peking Union Medical College Hospital on 21 March 2017 (approval no. ZS-1289X). Study findings will be disseminated through presentations at scientific conferences or publications in peer-reviewed journals.Trial registration numberChinese Clinical Trial Registry (ChiCTR2000029298).Protocol versionV.4CP.B2 (15 June 2020).

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Jaw Exercise Therapy and Psychoeducation to Reduce Oral Parafunctional Activities for the Management of Persistent Dentoalveolar Pain

Pain Research and Management ◽

10.1155/2018/5042067 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

Izumi Makino ◽

Young-Chang Arai ◽

Shuichi Aono ◽

Masayuki Inoue ◽

Hiroki Sakurai ◽

...

Keyword(s):

Standard Deviation ◽

Combination Therapy ◽

Pain Intensity ◽

Rating Scale ◽

Numerical Rating Scale ◽

End Of Treatment ◽

Before And After ◽

Numerical Rating ◽

Therapy Treatment ◽

Nonpharmacological Treatments

Objective. To retrospectively analyze the effects of our original combination therapy treatment on patients with nonodontogenic persistent dentoalveolar pain. Methods. Twenty-one patients suffering from persistent dentoalveolar pain (nineteen females and two males; mean age ± standard deviation: 55.7 ± 19.6 years) participated in this study. They were treated with a therapy combination of jaw exercise and psychoeducation to reduce oral parafunctional activities every month. The intensity of pain in these subjects was evaluated using a numerical rating scale (NRS) before and after treatment. Results. The NRSs at the baseline ranged from 5 to 10 (median, 8), from 0 to 10 (median, 2) at one month after treatment, from 0 to 10 (median, 1) at three months after treatment, and from 0 to 10 (median, 0) at the end of treatment. Pain intensity after treatment improved significantly. Conclusion. There was a significant reduction in pain after our combination of therapies as nonpharmacological treatments, and therefore this treatment could be useful in the management of NPDP patients.

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