clinical pain measurement methods
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CLINICAL PAIN MEASUREMENT CLINICAL PAIN MEASUREMENT METHODSMETHODS
Z. TURK, D. ČELAN, A. AMMERZ. TURK, D. ČELAN, A. AMMERUKC MARIBOR, UKC MARIBOR,
Institute of Physical and Rehabilitation Medicine Institute of Physical and Rehabilitation Medicine
SEDARE DOLOREM SEDARE DOLOREM DIVINUM ESTDIVINUM EST
DOLOMETERDOLOMETER
ALGOMETER?ALGOMETER?
Pain evaluation through centuries:
sadness, joy, suffering, torture, bluffing, etc.
PAIN IS INFORMATION PROVIDED BY THE PATIENT – INJURED PERSON AND
EVALUATED BY A THERAPIST
PAIN CAN BE: •PHYSICAL
•PSYCHOLOGICAL
•PSYCHOGENIC
•SOCIAL
•COGNITIVE
•EMOTIONAL
•SENSITIVE
•FUNCTIONAL
•MOTIVATIONAL
MEASUREMENT MEASUREMENT METHODSMETHODS
Descriptive terms (no pain, mild, moderate, severe Descriptive terms (no pain, mild, moderate, severe pain)pain)
Numeric (0 to 10)Numeric (0 to 10)
DescriptiveDescriptive
VisualVisual
Questionnaires andQuestionnaires and
Instrumental measurement (laser, EMG, clinical Instrumental measurement (laser, EMG, clinical measurement)measurement)
Visual scales
VAS (visual analogue scale)
Different forms – numbers, images, contacts, for the purpose of analyzing results
UNIT FOR MEASURING PAIN
– PAIN INTENSITY ???
ALGORITHM - BONICAALGORITHM - BONICA
ACUTE PAINACUTE PAIN
(duration, intensity, ,measuring methods -VAS, (duration, intensity, ,measuring methods -VAS, numeric scales)numeric scales)
CHRONIC PAINCHRONIC PAIN
(visual, verbal, numeric, questionnaires, (visual, verbal, numeric, questionnaires, psychosocial tests)psychosocial tests)
CLINICAL EXAMINATIONCLINICAL EXAMINATION
InspectionInspection• SKIN: perspiration, color, sensitivity, spasticity, SKIN: perspiration, color, sensitivity, spasticity,
formform
PalpationPalpation• Pressure, kneading, compression (algometer, Pressure, kneading, compression (algometer,
dolometer)dolometer)
Neurological examinationsNeurological examinations
Neurophysiological examinations (EMG)Neurophysiological examinations (EMG)
Laser measurementsLaser measurements
ALGOMETERALGOMETER
MEASURE PAIN INTENSITYMEASURE PAIN INTENSITY
Pain is what the patient reportsPain is what the patient reports
Belive the patientBelive the patient
Measure and systematically recordMeasure and systematically record
PAIN MEASUREMENTPAIN MEASUREMENTMETHODSMETHODS
Descriptive TermsDescriptive Terms– No pain, Mild, Moderate, SevereNo pain, Mild, Moderate, Severe
Numerical ScoresNumerical Scores– Number 0 throughNumber 0 through 1010
Faces ScalesFaces Scales
Visual AnalogueVisual Analogue
Multidimensional InstrumentsMultidimensional Instruments– McGill Pain QuestionnaireMcGill Pain Questionnaire
PALM PILOT - PAIN METERPALM PILOT - PAIN METER
Palm top computerPalm top computer
Measures 4 dimensionsMeasures 4 dimensions– Pain IntensityPain Intensity– Pain ReliefPain Relief– MoodMood– Side EffectsSide Effects
One composite score from 0 to 10One composite score from 0 to 10
PALM PILOT PALM PILOT – PAIN INTENSITY – PAIN INTENSITY
SCREENSCREEN
0 – None0 – None1 – Minimal1 – Minimal2 – Mild2 – Mild3 – Annoying3 – Annoying4 – Moderate4 – Moderate5 – Incomfortable5 – Incomfortable6 – Severe6 – Severe7 – Dreadful7 – Dreadful8 – Very Severe8 – Very Severe9 – Horrible9 – Horrible10 – Worst Possible10 – Worst Possible
PRN Pain
Treatment Cycle
PatientSleeps
PatientAwakes
PatientHas Pain
CalsNurse
NurseEvaluates
Signs OutMedication
PreparesInjection
Gives Injection
MedicationAbsorbed
Pain isRelleved
PAIN DIMENSIONSPAIN DIMENSIONS
Social & Cultural ExperiencesSocial & Cultural Experiences
Tissue
Damage
Emotions & Motivation
Cognitive Conceptual
Past Experiences, Current, Espectation, Secondary Gain,Loss, Threat Perception
Epression, Fear, Anger, Arousal & Behavioural Adaptations
PAIN
PAIN PAIN
Medical Care
Psychological Support
Social Services
Vocational Rehabilitation
Clinical Pharmacology
MULTI-
DISCIPLINARY
PAIN
TEAM
PATIENT
ALGOLOGIST
– WHO IS THIS?
PAINPAINTREATMENTTREATMENT
SYMPTOMATICSYMPTOMATIC
PATHOPHYSIOLOGICALPATHOPHYSIOLOGICAL
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