• Title/Summary/Keyword: Pain scales

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Investigation on Cancer Pain Assessment (암성 통증의 평가방법에 대한 고찰)

  • Cho, Jung-Hyo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.2
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    • pp.548-553
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    • 2007
  • In general, cancer pain is neither fully recognized nor adequately treated. The inadequate pain control is due to failure of accurate assessment of cancer pain. This study was aimed to understand various characters of cancer pain and investigate available assessment scales which have been designed for, or frequently used with people with cancer pain. A total of 23 articles were selected from two different databases. The selected articles were analyzed according to three aspects of initial assessment, patient self-report and assessment of the outcomes of pain management. The characters of cancer pain is complex and includes physical, psychosocial, and spiritual dimension. Also, subjective pain can be classified into at least four specific factors, such as pain intensity, pain affect, pain relief, and pain quality. Based on various classification, the pain assessment scales can be divided into unidimensional or multidimensional. Among the more commonly used clinical tools are numeric rating scales, verbal rating scales, visual analog scales, and picture scales. Above all, in order to assess cancer pain objectively, the clinician must select appropriate assessment instruments which reflect pain definition and clinical purpose.

Pain measurement in oral and maxillofacial surgery

  • Sirintawat, Nattapong;Sawang, Kamonpun;Chaiyasamut, Teeranut;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.253-263
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    • 2017
  • Regardless of whether it is acute or chronic, the assessment of pain should be simple and practical. Since the intensity of pain is thought to be one of the primary factors that determine its effect on a human's overall function and sense, there are many scales to assess pain. The aim of the current article was to review pain intensity scales that are commonly used in dental and oral and maxillofacial surgery (OMFS). Previous studies demonstrated that multidimensional scales, such as the McGill Pain Questionnaire, Short form of the McGill Pain Questionnaire, and Wisconsin Brief Pain Questionnaire were suitable for assessing chronic pain, while unidimensional scales, like the Visual Analogue Scales (VAS), Verbal descriptor scale, Verbal rating scale, Numerical rating Scale, Faces Pain Scale, Wong-Baker Faces Pain Rating Scale (WBS), and Full Cup Test, were used to evaluate acute pain. The WBS is widely used to assess pain in children and elderly because other scales are often difficult to understand, which could consequently lead to an overestimation of the pain intensity. In dental or OMFS research, the use of the VAS is more common because it is more reliable, valid, sensitive, and appropriate. However, some researchers use NRS to evaluate OMFS pain in adults because this scale is easier to use than VAS and yields relatively similar pain scores. This review only assessed pain scales used for post-operative OMFS or dental pain.

Practical statistics in pain research

  • Kim, Tae Kyun
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.243-249
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    • 2017
  • Pain is subjective, while statistics related to pain research are objective. This review was written to help researchers involved in pain research make statistical decisions. The main issues are related with the level of scales that are often used in pain research, the choice of statistical methods between parametric or nonparametric statistics, and problems which arise from repeated measurements. In the field of pain research, parametric statistics used to be applied in an erroneous way. This is closely related with the scales of data and repeated measurements. The level of scales includes nominal, ordinal, interval, and ratio scales. The level of scales affects the choice of statistics between parametric or non-parametric methods. In the field of pain research, the most frequently used pain assessment scale is the ordinal scale, which would include the visual analogue scale (VAS). There used to be another view, however, which considered the VAS to be an interval or ratio scale, so that the usage of parametric statistics would be accepted practically in some cases. Repeated measurements of the same subjects always complicates statistics. It means that measurements inevitably have correlations between each other, and would preclude the application of one-way ANOVA in which independence between the measurements is necessary. Repeated measures of ANOVA (RMANOVA), however, would permit the comparison between the correlated measurements as long as the condition of sphericity assumption is satisfied. Conclusively, parametric statistical methods should be used only when the assumptions of parametric statistics, such as normality and sphericity, are established.

Personality Profile of TMD Patients from the Viewpoint of Pain (통증을 중심으로 본 악관절장애 환자의 인성적 경향에 대한 고찰)

  • Sang-Cheol Yoon;Jae-Kap Choi
    • Journal of Oral Medicine and Pain
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    • v.20 no.1
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    • pp.79-87
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    • 1995
  • Personality characteristics of third decade female TMD patients was studied by means of SCL-90-R test. 112 TMD patients and 96 dental controls were subjected at the department of Oral medicine, Kyungpook National University Hospital. All the patients were divided into 3 groups according to their pain profile namely, MPDS, ID with Pain and ID with out Pain, and dental controls were divided into 2 groups manely, Dental Controls with Pain and Dental Controls without Pain for comparison. The obtained results were as follows : 1. Mean T-scores of SCL-90-R primary scales and global indexes in the patient and control group were within normal range. 2. When compared between groups with pain, MPDS group were significantly higher in scales of SOM, 0-C, I-S, HOS and PHOB than ID with Pain group and in scales of SOM, I-S. DEP, HOS and PHOM than Dental Controls with Pain group. 3. When compared with ID and Control groups in same pain condition, there were no significant differences between ID without pain and Dental Controls without Pain group. 4. When compared between groups with pain and groups without pain, there were significant differences in scales of SOM and O-C between Dental Controls with Pain and Dental controls without Pain group.

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A Clinical Study of Acute Low Back Pain Patients in Muscular Origin Through Symptom Check List-90-Revision(SCL-90-R) (급성 근육기인성 요배부 통증환자에 대한 간이정신진단검사를 통한 고찰)

  • Lee, Kang-Su
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.1
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    • pp.1-14
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    • 2006
  • Objectives : The causative pathology of acute muscular pain cannot be defined in many patients. To evaluate the relations between mental state and acute muscular pain patients, the author surveyed symptom check list-90-Revision(SCL-90-R) in patients with acute muscular pain. Materials and Methods : From November 2004 to June 2005, a questionnaire including SCL-90-R was given to patients(52 persons) who visited our department for acute(<7days)muscular pain of neck(22 persons) or low back(30 persons). Fifty two patients(30 male, 22 female) completed SCL-90-R Results : 1. Mean values of T-scores on all 9 basic scales in the patients groups were within normal range. but T-scores SOM in the patients groups were significantly very higher than those in Normal groups(p<0.01). 2. The T-scores of SOM In low back pain patients were significantly higher than those in Normal groups(p<0.05). 3. There was no significant difference in all scales between acute muscular pain and L-spine HIVD patients groups. 4. There was no significant difference in all scales between acute muscular pain and general back pain patients groups. 5. There was no significant difference in all scales between male and female in the patients groups. Conclusion : It is concerned between T-scores on all 9 bas κ scales of SCL-90-R and acute muscular pain. Especially acute muscular pain of back has a relation to somatization of T-scores on all 9 basic scales of SCL-90-R.

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A Review of Clinical Trials for Development of Assessment Criteria for Chronic Low Back Pain (만성 요통에 대한 한의학적 평가척도 개발을 위한 임상연구 실태조사)

  • Kim, Ji-Hye;Nam, Dong-Woo;Kang, Jung-Won;Kim, Eun-Jung;Kim, Kap-Sung;Kang, Sung-Keel;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.26 no.6
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    • pp.215-224
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    • 2009
  • Objectives : Low back pain is the most prevalent condition for receiving Korean traditional medical treatment. The aim of this review is to provide fundamental data for development of low back pain classification and assessment criteria which can be used in clinical trials and clinical practice. Methods : Domestic and international clinical studies on oriental medicine treatment for low back pain were searched through on-line databases. The searched articles were reviewed and the evaluation tools used in the studies were investigated. Results : A total of 38 possibly relevant articles in Pubmed were identified, of which 34 articles included assessment criteria for low back pain. And 38 articles were reviewed in the Journal of Korean Oriental Medicine and the Journal of Korean Acupuncture & Moxibustion Society. 29 articles used pain scales, 24 used functional scales, and 20 among 34 articles in PubMed used both pain and functional scales. The majority of articles which published in Korea used worthless assessment scales of simple grades. There was no articles which used assessment scales related to the concepts of Korean traditional medicine. Conclusions : Our review of articles suggests that we would use both pain and functional scales. Future assessment scales should include the concepts of Korean traditional medicine.

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Validity, Reliability and Efficiency of Pain Self-report Scale in Elderly with Dementia (치매노인의 통증사정에 대한 자가보고 도구의 타당도, 신뢰도 및 효율성 검증)

  • Ryoo, Eon-Na;Park, Kyung-Sook
    • Korean Journal of Adult Nursing
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    • v.23 no.2
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    • pp.111-122
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    • 2011
  • Purpose: The aim on this study was to establish the validity, reliability and efficiency of a Pain Self-Report Scale for elderly with dementia and compare these results with an observational pain rating scale. Methods: Study subjects were 136 elderly with dementia who were residents in a nursing home, geriatric hospital, or day care center. The subject's pain was measured by five self-report scales and observational scale. DS-DAT (discomfort scale-dementia of the Alzheimer's type) was used for pain behavior observational measure. Cognitive state was assessed using the MMSE (Mini-Mental State Examination). Results: Observational rating correlated moderately with self-report (r=.225~.585, p<.05) and tended to underestimate pain intensity. Test-retest reliability was high for all five self-report scales, and the correlation between these scales was very strong (r=.735~.856, p<.05). Comprehension rate of VDS (verbal descriptor scale) was 88.3%, and NRS (numeric rating scale) 69.9%, FPS (face pain scale) 66.9%, HVAS (horizontal visual analog scale) and VVAS (vertical visual analog scale) 65.4%. Conclusion: Nurses should not apply observational scales routinely in demented patients as many of these are capable of reporting their own pain. Self-report, the highest standard of pain measurement can be reliably performed in a large proportion of demented elderly.

Comparison Study with Pain Assessment Tools of Pain Measurement in Children for Intravenous Catheter Placement in the Computed Tomography (CT 검사에서 소아 환자의 정맥 카데터 삽입 통증에 대한 측정 도구 비교)

  • Kweon, Dae-Cheol;Jang, Keun-Jo
    • The Journal of the Korea Contents Association
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    • v.8 no.2
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    • pp.205-212
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    • 2008
  • Needle phobia of medical devices is a significant problem in children patients. We conducted study in 130 pediatric patients aged $8{\sim}13$(mean age 10.5) who had venipuncture performed in a computed tomography. This review aims to explore the research available relating to three commonly used pain rating scales of children, the visual analogue scale(VAS), numeric pain rating scale(NPRS) and Wong-Baker faces pain scale(WBFPS) with scores. Its validity is supported by a strong positive correlation with the three-pain rating scales(correlations ranging from 0.70 to 0.92) measure in children. There were no significant differences between the means on the VAS and either of the pain rating scales. It has the advantage of being suitable for use with the most widely used metric for scoring($0{\sim}10$), and conforms closely to a linear interval scale. These scales presented moderate to good correlation and moderate agreement, sufficient for valid use in children. All three pain-rating scales are valid, reliable and appropriate for use in intravenous catheter placement.

Epidural Infusion of Morphine and Levobupivacaine through a Subcutaneous Port for Cancer Pain Management

  • Heo, Bong Ha;Pyeon, Tae Hee;Lee, Hyung Gon;Kim, Woong Mo;Choi, Jeong Il;Yoon, Myung Ha
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.139-144
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    • 2014
  • Background: To manage intractable cancer pain, an alternative to systemic analgesics is neuraxial analgesia. In long-term treatment, intrathecal administration could provide a more satisfactory pain relief with lower doses of analgesics and fewer side-effects than that of epidural administration. However, implantable drug delivery systems using intrathecal pumps in Korea are very expensive. Considering cost-effectiveness, we performed epidural analgesia as an alternative to intrathecal analgesia. Methods: We retrospectively investigated the efficacy, side effects, and complications of epidural morphine and local anesthetic administration through epidural catheters connected to a subcutaneous injection port in 29 Korean terminal cancer patients. Patient demographic data, the duration of epidural administration, preoperative numerical pain rating scales (NRS), side effects and complications related to the epidural catheterization and the drugs, and the numerical pain rating scales on the 1st, 3rd, 7th and 30th postoperative days were determined from the medical records. Results: The average score for the numerical pain rating scales for the 29 patients decreased from $7{\pm}1.0$ at baseline to $3.6{\pm}1.4$ on postoperative day 1 (P < 0.001). A similar decrease in pain intensity was maintained for 30 days (P < 0.001). Nausea and vomiting were the most frequently reported side effects of the epidural analgesia and two patients (6.9%) experienced paresthesia. Conclusions: Epidural morphine and local anesthetic infusion with a subcutaneous pump seems to have an acceptable risk-benefit ratio and allows a high degree of autonomy to patients with cancer pain.

Comparison of Visual Analogue Scale, Categorical Scale and Satisfaction for Postoperative Pain (수술 후 통증 평가를 위한 Visual Analogue Scale, Categorical Scale 그리고 환자 만족도와의 비교)

  • Kim, Yong-Ik;Nam, Sang-Goo;Hong, Seung-Taek;Kang, Kyu-Sik;Park, Wook
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.156-163
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    • 2001
  • Background: The categorical scales and visual analogue scales (VAS) are methods used for evaluating variations of postoperative pain intensity. Several studies have introduced the idea that there is a clear correlation between visual scales and categorical scales. However, when VAS is the only pain measure in the study, we do not know what point on the VAS represents a category on the categorical scale and their degree of correlation with satisfaction for postoperative pain. Methods: 252 patients who had undergone elective surgery were studied. A 5-point categorical scale (none, mild, moderate, severe, worst possible pain), a 0-100 mm VAS (no pain to worst possible pain) and patient satisfaction score were checked 24 hours after surgery using a pain questionnaire and VAS tool. Results: The mean VAS score of the 14 patients reporting 'no-pain' was $1.9{\pm}0.9$, $23.9{\pm}1.0$ for the 132 patients reporting 'mild-pain', $47.2{\pm}1.1$ for the 82 patients reporting 'moderate-pain' and $67.5{\pm}2.8$ for the 24 patients reporting 'severe-pain'. Of the patients reporting moderate pain, 85% scored over 45.6 mm on the corresponding VAS, with a mean score 47.2 mm. The mean satisfaction scores were $90.6{\pm}2.7$ for the 'no pain', patients, $75.1{\pm}1.3$ for ‘mild pain', $58.3{\pm}1.5$ for 'moderate pain', and $55.1{\pm}4.0$ for 'severe pain' patients. The categorical scale was significantly correlated with VAS (P < 0.01). The satisfaction score was significantly inversely correlated with VAS (P < 0.01). Conclusions: Our results indicate that if a patient records a VAS score in excess of 45.6 mm they would probably have recorded at least moderate pain on a 5-point categorical scale. The categorical scale can be used properly for postoperative pain measurement with VAS. More research is required for the development of suitable pain descriptor for a categorical scale and pain questionnaire in Korean.

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