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CLINICAL PAIN MEASUREMENT METHODS. Z. TURK, D. ČELAN, A. AMMER UKC MARIBOR, Institute of Physical and Rehabilitation Medicine. SEDARE DOLOREM DIVINUM EST. DOLOMETER ALGOMETER?. PAIN IS INFORMATION PROVIDED BY THE PATIENT – INJURED PERSON AND EVALUATED BY A THERAPIST.
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CLINICAL PAIN MEASUREMENT METHODS Z. TURK, D. ČELAN, A. AMMER UKC MARIBOR, Institute of Physical and Rehabilitation Medicine
SEDARE DOLOREM DIVINUM EST DOLOMETER ALGOMETER?
PAIN IS INFORMATION PROVIDED BY THE PATIENT – INJURED PERSON AND EVALUATED BY A THERAPIST Pain evaluation through centuries: sadness, joy, suffering, torture, bluffing, etc.
PAIN CAN BE: • PHYSICAL • PSYCHOLOGICAL • PSYCHOGENIC • SOCIAL • COGNITIVE • EMOTIONAL • SENSITIVE • FUNCTIONAL • MOTIVATIONAL
MEASUREMENT METHODS Descriptive terms (no pain, mild, moderate, severe pain) Numeric (0 to 10) Descriptive Visual Questionnaires and Instrumental measurement (laser, EMG, clinical measurement)
UNIT FOR MEASURING PAIN – PAIN INTENSITY ??? Visual scales VAS (visual analogue scale) Different forms – numbers, images, contacts, for the purpose of analyzing results
ALGORITHM - BONICA • ACUTE PAIN (duration, intensity, ,measuring methods -VAS, numeric scales) • CHRONIC PAIN (visual, verbal, numeric, questionnaires, psychosocial tests)
CLINICAL EXAMINATION • Inspection • SKIN: perspiration, color, sensitivity, spasticity, form • Palpation • Pressure, kneading, compression (algometer, dolometer) • Neurological examinations • Neurophysiological examinations (EMG) • Laser measurements
MEASURE PAIN INTENSITY • Pain is what the patient reports • Belive the patient • Measure and systematically record
PAIN MEASUREMENTMETHODS • Descriptive Terms • No pain, Mild, Moderate, Severe • Numerical Scores • Number 0 through 10 • Faces Scales • Visual Analogue • Multidimensional Instruments • McGill Pain Questionnaire
PALM PILOT - PAIN METER • Palm top computer • Measures 4 dimensions • Pain Intensity • Pain Relief • Mood • Side Effects • One composite score from 0 to 10
PALM PILOT – PAIN INTENSITY SCREEN 0 – None 1 – Minimal 2 – Mild 3 – Annoying 4 – Moderate 5 – Incomfortable 6 – Severe 7 – Dreadful 8 – Very Severe 9 – Horrible 10 – Worst Possible
Patient Has Pain Patient Awakes Cals Nurse Patient Sleeps Nurse Evaluates PRN Pain Treatment Cycle Pain is Relleved Signs Out Medication Prepares Injection Medication Absorbed Gives Injection
PAIN DIMENSIONS Social & Cultural Experiences Tissue Damage PAIN PAIN Emotions & Motivation Cognitive Conceptual PAIN Past Experiences, Current, Espectation, Secondary Gain,Loss, Threat Perception Epression, Fear, Anger, Arousal & Behavioural Adaptations
PATIENT MULTI- DISCIPLINARY PAIN TEAM Medical Care Psychological Support Social Services Vocational Rehabilitation Clinical Pharmacology
ALGOLOGIST – WHO IS THIS?
SYMPTOMATIC PATHOPHYSIOLOGICAL PAINTREATMENT