The author investigated pain experiences of 90 cancer patients and adequacy of pain treatment they have received during their stay at a large medical center in T city between October 1994 and August 1995. Pain was assessed by the Shortened BPQ and results are summarized as follows: As for ratings of "worst pain" during the 24 hour period, 70% of the patients reported they had "severe" pain. As for ratings on "pain now" 43% of the cancer patients reported "moderate to severe" pain. Over 46% of the patients reported a pain relief score of 0(not at all) or 1(somewhat) even after receiving pain medication. Adequacy of analgesic treatment was evaluated by comparing the patient's reported level of pain and the analgesic use, namely, the pain management index(PMI). The PMI indicated that 58% of the patients were undertreated for the pain control. In review of nurse's notes, systematic pain assessment was scarcely recorded, although pain documentation appeared in 70% of the notes; and the contents were mostly simple description. In conclusion, the results of patient's pain ratings, the PMI and poor pain documentation in the nurse's notes implied poor pain assessment and management.
Humans ; Pain Management* ; Pain Measurement

Bias ; Humans ; Pain Measurement ; Pain, Postoperative

Background and Objective of the Study : Trigeminal neuralgia (TN) affects 4-5 people per 100,000 population. Because of its key feature - sudden intense facial pain, immediate and long-term treatment is warranted. The newly validated Penn Facial Pain Scale (PFPS) is of great value for assessment of how trigeminal pain and its treatment affect our patients’ lives. This study translated the PFPS to a Filipino version which can be used with ease in our setting. Methodology Study Design Validity Study Methods : Forward translation was carried out by an expert. The initial output was sent to 10 Neurologists for content and face validity. The experts rated each item’s relevance and through item level content validity index, items which scored >0.80 were accepted and those that scored lower were subjected to discussion by the investigators. The revised questionnaire was then administered to 8 TN patients for face validity. The fi nal output was back translated and compared to the original PFPS. Results Content and face validity as assessed by 10 neurologists showed that all questions were relevant. Some words were edited according to their suggestions. Eight TN patients voluntarily answered the edited version of the questionnaire for face validity and cognitive debriefi ng. No further changes were made to the edited questionnaire which was then back translated. The back translation was found to be similar to the original PFPS. Conclusion The Filipino version is similar to the original PFPS and can be used in evaluation of TN. A Phase 2 reliability study should be ideally done prior to utilization in clinical setting.
Trigeminal Neuralgia ; Facial Pain ; Pain Measurement

Humans ; Infant, Newborn ; Pain ; diagnosis ; physiopathology ; Pain Management ; Pain Measurement

Humans ; Infant, Newborn ; Pain ; diagnosis ; etiology ; Pain Management ; Pain Measurement

Background:The FLACC (Facial expression, Leg movement, Activity, Cry, Consalability) behavioral pain assessment scale was developed and validated by Merkel and colleagues among American children last 1997 for autepain assessment of children 2 months to 7 years of age. Since then, it has been validated among other nationalities. It is now being used in Scotland, Australia, Canada and Thailland. This study aimed to determine the inter-reter reliability and construct validity of the FLACC on Filipino posoperative pediatric patients. Methods: A total of 106 children less than 5 years of age (1,68+1.46 years) who were admitted in the Philippine General Hospital Post Anesthesia Care Unit (PACU) were included. Those who are operated on an emergency basis, had neurologic impairment, had developmental delay and required menchanical ventilation postoperatively were excluded. Prior to the data collection phase, the PACU nurses were trained to use the FLACC scale using videotapes of postoperative children. Whenever possible, children were silmultaneuosly rated by two idependent ratersdurig their stay in the PACU. Those with FLACC scores>4 were given an intervention and the pain measurement was repeated and reported accordingly. Results: Inter-rater reliability was good to very good with kappa values for the pain behavior items ranging from 0.75 to 0.82. Construct validity ws established by showing a statistically significant reduction (p<0.001) beteen the pre-intervention score and post-intervention score using Wilcoxon signed rank test. Conclusion: The FLACC exhibited bith inter-rater reliability and contruct validity in the measurement of acute postoperative pain in Filipino children less than 5 years old.
Human ; Child Preschool ; Infant ; PAIN MEASUREMENT ; PAIN ; PEDIATRICS ; PAIN, POSTOPERATIVE

OBJECTIVE: The purpose of this study was to compare the radiological and neurological outcomes between two atlantoaxial fusion method for atlantoaxial stabilization; C1 lateral mass-C2 pedicle screws (screw-rod constructs, SRC) versus C1-2 transarticular screws (TAS). METHODS: Forty-one patients in whom atlantoaxial instability was treated with atlantoaxial fixation by SRC group (27 patients, from March 2005 to May 2011) or TAS group (14 patients, from May 2000 to December 2005) were retrospectively reviewed. Numeric rating scale (NRS) for pain assessment, Oswestry disability index (ODI), and Frankel grade were also checked for neurological outcome. In radiologic outcome assessment, proper screw position and fusion rate were checked. Perioperative parameters such as blood loss during operation, operation time, and radiation exposure time were also reviewed. RESULTS: The improvement of NRS and ODI were not different between both groups significantly. Good to excellent response in Frankel grade is shown similarly in both groups. Proper screw position and fusion rate were also observed similarly between two groups. Total bleeding amount during operation is lesser in SRC group than TAS group, but not significantly (p=0.06). Operation time and X-ray exposure time were shorter in SRC group than in TAS group (all p<0.001). CONCLUSION: Both TAS and SRC could be selected as safe and effective treatment options for C1-2 instability. But the perioperative result, which is technical demanding and X-ray exposure might be expected better in SRC group compared to TAS group.
Hemorrhage ; Humans ; Pain Measurement ; Retrospective Studies

BACKGROUND: A majority of patients undergoing chemical peeling complain of pain severe enough to disturb the process of the peeling. However, there has been few controlled studies on pain control during chemical peeling. OBJECTIVES: We evaluated the efficacy and safety of pretreatment with intramuscular ketorolac (Tarasyn, 30 mg) and oral diazepam(Valium, 5 mg) in comparison with control and diazepam groups, and compared the sensitivity of pain between two sexes. METHODS: The patients were randomly assigned to one of three groups; control, diazepam, and ketorolac plus diazepam groups. Pain intensity was assessed 5 times at every ten minutes from the beginning of the peeling using visual analog scale(VAS). RESULTS: At every 10 minutes of pain assessment, ketorolac plus diazepam group recorded the lowest VAS among the three groups. Except at the first 10 minutes, nificant. There was no significant difference in the pain intensity between the sexes at all five times. After application of Jessner`s solution, there was significant increase of VAS in all groups. CONCLUSION: The ketorolac pretreatment is a safe and effective modality of pain relief prior to chemical peeling without the adverse reactions.
Diazepam ; Humans ; Ketorolac* ; Pain Measurement ; Premedication*

PURPOSE: This study was performed to evaluate the effectiveness of a pain assessment education program developed for nurses. METHODS: Research design of this study was nonequivalent control group quasi-experimental study. Subjects for this study were 56 nurses for control group, and 53 nurses for experimental group. The experimental group participated in pain assessment education program. Data were collected before and 6 months after the program and analyzed using the SPSS 12.0 program. RESULTS: The results of this study were as follows: In pretest, there were no significant differences in general characteristics, knowledge of pain, attitude toward pain and pain assessment behaviors. In post test, the experimental group had significantly higher scores of pain knowledge scores and pain assessment behaviors than control group. However, attitude toward pain remained unchanged. CONCLUSION: According to the results, pain assessment education program was effective in improving pain knowledge and pain assessment behavior.
Education* ; Nursing ; Pain Measurement* ; Research Design

To evaluate the clinical value of a new self assessment method of pain, so called pain rating score(PRS), we performed the visual analogue scale, verbal rating scale, McGill pain questionnaire, and PRS on 60 patients with complained neuro-musculo-skeletal pain. The results showed that the reliability of PRS was very high. The PRS was a simple, easy, and comprehensive method to assess the pain for its intensity, frequency, duration, and aggravating factors. The PRS was very sensitive for the change of pain. Based on the above results we have concluded that, the new self assessment method of pain, pain rating score(PRS), is a valuable and useful clinical method which is simple, easy to perform and comprehensive.
Humans ; Pain Measurement ; Surveys and Questionnaires ; Self-Assessment*