8.3.2 Flashcards
Subjective Measures of Pain
Subjective measures, like self-reports, are crucial for understanding the severity and daily impact of a patient’s pain.
Clinical Interviews for Chronic Pain
Clinical interviews are used to assess chronic pain, providing insights into a patient’s emotional state and their beliefs about the causes of pain.
Psychometric Tests in Clinical Interviews
Clinical interviews may use psychometric tests to assess pain type, intensity, emotional distress, and a patient’s daily functioning.
Strength of Clinical Interviews
A strength of clinical interviews is their ability to allow tailored treatment plans, improving patient adherence and treatment success.
Limitations of Clinical Interviews
A limitation of clinical interviews is that they rely on effective communication and trust between the patient and physician, which may not be present in all cases.
McGill Pain Questionnaire Overview
The McGill Pain Questionnaire (MPQ), created by Melzack and Torgerson (1971), categorizes pain descriptions into sensory, affective, evaluative, and miscellaneous aspects.
McGill Pain Questionnaire Categories
The MPQ is divided into four categories: sensory (1–10), affective (11–15), evaluative (16), and miscellaneous (17–20).
Pain Rating Index (PRI)
The Pain Rating Index (PRI) is a key result measurement in the MPQ. A high score indicates high pain levels.
MPQ Measurement of Pain
The MPQ uses the number of words chosen by patients and their present pain intensity (PPI) as key measures of pain severity.
Strengths of MPQ
The MPQ is reliable, with studies like Ferraz (1990) showing a high correlation between test and retest results (r = +0.96).
Validity of MPQ
The MPQ is valid; for instance, Byrne et al. (1982) found that MPQ results for back pain patients aligned with previous studies.
Limitations of MPQ
One limitation of the MPQ is that quantitative pain measures may not accurately capture a patient’s full experience of pain, as descriptive words may not fit their perception.
Visual Analogue Scale (VAS) Overview
The Visual Analogue Scale (VAS) measures pain along a continuum, allowing patients to indicate the intensity of their pain using pictures or a line.
Strengths of VAS
The VAS is quick, easy to use, and offers a valid representation of pain intensity along a continuum without gaps.
Limitations of VAS
A limitation of the VAS is that it doesn’t allow patients to elaborate on the pain’s impact or their experience, offering only a basic measurement of pain.
UAB Pain Behaviour Scale Overview
The UAB Pain Behaviour Scale measures observable pain behaviors, both verbal and non-verbal, over a three-week period using a three-point scale.
Strengths of UAB Pain Behaviour Scale
The UAB scale is quick to score and easy to use. It can be used with large groups, including patients unable to complete self-reports.
Limitations of UAB Pain Behaviour Scale
A limitation of the UAB scale is that it depends on the observer’s accuracy in recording pain behaviors and may not correlate well with self-reports.
Brudvik et al. (2016) Study Context
Brudvik et al. (2016) studied pain estimation differences between doctors, parents, and children, showing doctors often underestimate children’s pain.
Brudvik et al. (2016) Study Aims
The study aimed to explore the relationship between children’s self-reported pain and ratings by parents and doctors, as well as the impact on pain relief administration.
Brudvik et al. (2016) Research Method
Brudvik et al. (2016) used a field study with a correlational design, using questionnaires to assess children’s self-reported pain and pain ratings from parents and doctors.
Sample in Brudvik et al. (2016) Study
The study sample consisted of 243 pediatric patients aged 3–15 years, their parents, and 51 doctors.
Procedure in Brudvik et al. (2016) Study
Participants completed pain scales and questionnaires. Doctors and parents provided pain ratings, while the child’s medical condition was recorded.
Ethical Considerations in Brudvik et al. (2016) Study
Parents gave written consent, and extra support was provided to children if needed. Parents were informed of their right to withdraw at any time.
Brudvik et al. (2016) Results
Only 42% of children with severe pain were given pain relief, and only 14.3% of children who rated their pain as severe were administered medication.
Brudvik et al. (2016) Conclusion
The study concluded that doctors significantly underestimate pain in children, and suggested that parental reports should be taken more seriously in pain assessment.
Reliability of MPQ
The MPQ has been standardized and shown to have high reliability, such as in Ferraz’s (1990) test-retest analysis.
Generalisability of Brudvik et al. (2016) Study
Brudvik et al.’s study had limited generalisability since it was conducted in a single Norwegian emergency department, and doctors there did not specialize in pediatric care.
Validity of MPQ
The MPQ is considered valid. For example, Byrne et al. (1982) validated it by comparing it with previous research on back pain patients and finding similar results.
Brudvik et al. (2016) Validity
Brudvik et al.’s study had good ecological validity because it took place in a real-world hospital setting, where doctors followed their usual routines.
Brudvik et al. (2016) Bias in Reporting
In Brudvik et al., the children’s self-reports could have been influenced by their parents’ reactions, as they were often aware of each other’s ratings.
Idiographic vs. Nomothetic in Brudvik et al. (2016)
Brudvik et al. (2016) employed a nomothetic approach, using statistical analysis of pain ratings, whereas a more idiographic approach could have explored individual pain experiences.
Application to Paediatric Care
The findings of Brudvik et al. (2016) suggest that paediatric care in Norway should involve more attention to children’s and parents’ pain reports to ensure more accurate pain management.
Training Implications from Brudvik et al. (2016)
The study suggests that doctors should receive training to better assess children’s pain, as well as recognize the individual differences in pain perception and response to treatment.
Pain and Recovery Time
Pain perception is linked to recovery time and long-term issues such as hypersensitivity, making accurate pain assessment crucial for timely and effective treatment.
UAB Pain Behaviour Scale Strengths
The UAB scale is advantageous for large patient populations, including those unable to self-report, and is easy to use with quick scoring.
UAB Pain Behaviour Scale Weaknesses
However, the UAB scale relies heavily on the observer’s subjective interpretation and lacks a strong correlation with self-reported pain measures.
Strengths of Visual Analogue Scale
VAS is simple, efficient, and designed to display pain intensity on a continuum, making it easier for patients to represent their pain accurately.
Limitations of Visual Analogue Scale
VAS doesn’t allow patients to elaborate on their pain, offering only a basic measurement, which may not fully represent their pain experience.
McGill Pain Questionnaire Reliability
The McGill Pain Questionnaire (MPQ) is considered reliable due to high correlation coefficients in test-retest studies like Ferraz’s (1990).
Psychometric Measures in Clinical Pain Assessment
Psychometric measures, like the McGill Pain Questionnaire and VAS, help assess pain intensity and impact, aiding in personalized treatment planning.
Pain Rating Systems for Clinical Use
Both psychometric scales (like MPQ) and behavioral scales (like UAB) are important tools in clinical settings for assessing the subjective experience of pain.
Pain Assessment and Medication Administration
In Brudvik et al. (2016), the underestimation of children’s pain led to delayed and insufficient administration of pain relief medication.
Pain Assessment Across Age Groups
The underestimation of pain is a concern, particularly in children, as evidenced by studies showing doctors giving less pain medication to children than adults.
Strengths of Psychometric Pain Scales
Psychometric scales like the MPQ and VAS provide reliable and valid data for clinicians, helping to assess pain severity more effectively.
