Pain Interference

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PAIN INTENSITY AND PAIN INTERFERENCE AMONG TRAUMA PATIENTS: A LITERATURE REVIEW

PAIN INTENSITY AND PAIN INTERFERENCE AMONG TRAUMA PATIENTS: A LITERATURE REVIEW

The evidence from 10 studies indicates that trauma patients perceived moderate to severe pain, in particular during hospital stay. The NRS of BPI were most frequent tool used to assess pain of trauma patients. This includes pain interference. The available evidence seems to sugest that trauma patients perceived moderate to severe level of pain interference during hospitalization. In addition, current literatures on these variable abounds with examples of western studies in trauma patients due to MCV,fall, and burn injury.
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Patient-reported pain severity, pain interference and health status in HR+/HER2− advanced/metastatic breast cancer

Patient-reported pain severity, pain interference and health status in HR+/HER2− advanced/metastatic breast cancer

Results Overall, 173 oncologists and 739 patients participated. The majority of patients rated their worst pain, average pain and pain interference as mild (59%, 77% and 70%, respectively). Most patients (>90%) reported no problems or moderate problems for all items of the EQ-5D-3L. Current treatment had no significant associations with pain severity or interference. Patients on chemotherapy reported significantly higher proportions of moderate/extreme levels of anxiety/depression (66.7%) and significantly lower general health status (60.7) compared with those on endocrine therapy (53.1% and 64.4, respectively). Pain severity and interference, all EQ-5D-3L items except self-care and the EQ-5D-3L health utility index were also significantly associated with sites of metastases, with greater impact in patients with visceral and bone metastases than those with bone only or visceral only metastases. Significant associations were observed between pain and health status, with increased pain severity and pain interference associated with worse health utility and general health status.
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The Effect of Mental Health onto the Relationship of Pain Intensity and Pain Interference: A Moderation Analysis

The Effect of Mental Health onto the Relationship of Pain Intensity and Pain Interference: A Moderation Analysis

hand the found relationship between pain intensity and pain interference was of a small effect, too. As named above, this weak relationship might be caused by the fact that pain intensity is only one factor, which might induce pain interference (Loeser & Melzack, 1999). On the other hand, this finding could be also explained by the likewise weak relationship between mental health and pain interference. From the literature a statistically significant correlation between mental health and pain interference of a great effect could have been expected. This was not the case. A possible explanation for this could be that mental health may only have an effect on the psychological component of pain interference, i.e. satisfaction with life (Kerns et al., 1985). On the rather physiological components, i.e. an individual’s abilities and actions, mental health might have a weaker influence (Kerns et al., 1985). Thus, as mental health and pain intensity both seem to only partially affect pain interference, it might be explainable that they account just for a small amount of variance in pain interference.
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Minimally important differences for Patient Reported Outcomes Measurement Information System pain interference for individuals with back pain

Minimally important differences for Patient Reported Outcomes Measurement Information System pain interference for individuals with back pain

Low back pain (LBP) is a common problem that most people experience at some point during their life. LBP has an enormous impact at individual and societal level through- out the world. The social, cognitive, emotional, and physical consequences of pain on daily living have been referred to as pain interference (PI). 1,2 The National Institutes of

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Can cancer patients assess the influence of pain on functions? A randomised, controlled study of the pain interference items in the Brief Pain Inventory

Can cancer patients assess the influence of pain on functions? A randomised, controlled study of the pain interference items in the Brief Pain Inventory

erally recognised that pain measurement should use methods based on patients' self-report. Numeric scales are easy to understand and easy to score and have for these reasons been endorsed for use in both in cancer clinical trials and trials of chronic non-malignant pain [1,2]. Cleeland and colleagues developed the Brief Pain Inven- tory (BPI), a questionnaire designed to assess both pain severity and the interference from pain on seven areas of daily life [3]. The BPI is self-administrated and easily understood, and is translated and validated in several lan- guages [4-8]. The BPI is recommended as a research pain measurement tool by the Expert Working Group of the European Association of Palliative Care [1], and it is one of the most widely used multi-dimensional measures for cancer pain. Studies using the BPI have observed that the BPI interference scores are higher in patients with deterio- rated functional performance compared with scores in patients with normal or near normal functional perform- ance [6,7]. This difference was not explained by higher pain ratings in patients with lower functional perform- ance. This lack of relationship to pain intensity questions cancer patients' ability to report the influence on function from pain without a bias from decreased function caused by other factors. Given the ubiquitous presence of BPI in cancer pain research it is important to consider factors that may constrain the validity of the interference scale. To investigate whether pain interference items are answered independently of decreased function due to other causes than pain we compared the original BPI with a modified version. The modified version asks about degree of func- tions without specifying the cause of the impaired func- tions.
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Development of a pictorial scale for assessing functional interference with chronic pain: the Pictorial Pain Interference Questionnaire

Development of a pictorial scale for assessing functional interference with chronic pain: the Pictorial Pain Interference Questionnaire

There are several limitations to this study to be consid- ered in interpretation and for planning future research. This was a cross-sectional study, and therefore reliability of the PPIQ over repeat administrations was not assessed. It will be important in future studies to include repeat administra- tion of the PPIQ over a period of several days to weeks, to evaluate test–retest reliability, an important metric of the instrument’s reliability. As previously noted, this initial investigation was conducted with a literate and English-fluent sample. Results therefore cannot be generalized to other segments of the chronic pain population with lower literacy and fluency levels, pending further studies, as suggested earlier. Inclusion of cognitive screening in future research could also provide valuable data on the validity of the PPIQ for patients with mild cognitive deficits. Next, although the order of administration of the questionnaires was randomly varied, the inclusion of other language-based questionnaires
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<p>Pain symptomology, functional impact, and treatment of people with Neurofibromatosis type 1</p>

<p>Pain symptomology, functional impact, and treatment of people with Neurofibromatosis type 1</p>

Of the 255 participants, 220 (86%) reported some level of pain (a minimum of 1) in the last three months, and nearly 95% (n=240) reported some level of pain during their lifetime. On average, participants reported living with pain for 11.2 years (SD=4.9), and given the complexity of NF1, many reported pain from tumors in several regions of their body (Table 1). The least affected area was the pelvic region (35%); the most affected area was the arms (70%). A stepwise linear regression analysis indicated that body regions (back, chest) nearly approached signi fi cance when evaluating the pain symptoms and number of surgeries (p=0.054). Participants reported that multiple body areas were affected by tumors: 85% of individuals reported that more than two body areas were affected by tumors. There was a positive association between the number of affected areas and pain severity ratings (p=<0.001). The average aggregate pain severity index was 4.7, with an average aggregate pain interference of 4.9, indicating moderate levels of daily pain symptoms. Of those who reported pain, 19% (n=42) of individuals reported mod- erately high pain severity and pain interference as de fi ned by an aggregate score of 7 or higher. Stepwise linear regression analysis revealed a positive relation- ship between those taking prescription pain medication
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Patient-reported outcomes of pain and physical functioning in neurofibromatosis clinical trials

Patient-reported outcomes of pain and physical functioning in neurofibromatosis clinical trials

The REiNS PRO group is working to identify PRO measures that can be used consistently as endpoints across trials to assess clinical benefit of treatments to reduce tumors or other disease manifestations in indi- viduals with NF1, NF2, and SWN. The REiNS rec- ommendations for PROs in the domains of pain and physical functioning are presented with the understand- ing that further evaluation of the measures is needed in the NF population. Our group encourages researchers to use these PRO measures in upcoming NF studies. Final consensus recommendations regarding the one specific pain interference measure and format of the PROMIS-PF scales to use in NF clinical trials will be disseminated in a future publication based on results of additional published research.
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Pain catastrophizing is associated with poorer health-related quality of life in pediatric patients with sickle cell disease

Pain catastrophizing is associated with poorer health-related quality of life in pediatric patients with sickle cell disease

Results: Pain catastrophizing was inversely correlated with HRQoL measured by the PedsQL™ Generic Core Scale in children with SCD, while this was not noted in control participants. Psy- chological factors, such as anxiety and depressive symptoms, were also associated with poorer HRQoL in both children with SCD and controls. We did not find an association of psychological factors with prior health care utilization. Psychological factors such as anxiety and depressive symptoms were inversely correlated with pain interference, but not pain intensity in SCD. Conclusion: Catastrophizing is associated with poorer HRQoL in SCD, but in this study, it was not associated with pain intensity or interference and health care utilization in children with SCD. Further studies are needed to fully define the association of psychological factors including catastrophizing with QoL, pain burden, and SCD outcomes.
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The pain, depression, disability pathway in those with low back pain: a moderation analysis of health locus of control

The pain, depression, disability pathway in those with low back pain: a moderation analysis of health locus of control

for back pain intensity for those with high external beliefs (powerful others component) compared to those with low internal beliefs. This may offer some explanation why no moderation effect was found within the Externality model. It may be that because those with high Externality have an already stronger relationship with pain, there was less vari- ance for a moderation effect to occur. Examination of the beta coefficients in our model does show a generally stronger association between pain/pain interference and depressive symptoms in the Externality model, which may offer some explanation to the reported lack of effect. To investigate this further, the difference in mean scores for all variables within the model between high and low groups for both Internality and Externality was inspected. Results show a greater differ- ence in all variables for Internality between the Internality categories (eg, greater Student’s t-test scores), compared to the groups within Externality (data not shown); this poten- tially may have enabled a greater moderation effect to occur for Internality.
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Utility of the heated lidocaine/tetracaine patch in the treatment of pain associated with shoulder impingement syndrome: a pilot study

Utility of the heated lidocaine/tetracaine patch in the treatment of pain associated with shoulder impingement syndrome: a pilot study

eleven-point rating scale in which a score of 0 indicates no pain and a score of 10 represents the worst pain imaginable. Pain interference with general activity, normal work, and sleep during the previous 24 hours was also recorded using a similar eleven-point scale in which a score of 0 represents no interference and a score of 10 represents complete interference. In addition, they were instructed to record the use of any concomitant medications during the previous 24-hour period. Limits of internal rotation and abduction of the shoulder were assessed with a goniometer at baseline and on Day 14. On Day 14, patients were asked to grade their satisfaction of treatment by choosing one of the following categories: very dissatisfied, dissatisfied, no preference, satisfied, or very satisfied.
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Report of the NIH Task Force on Research Standards for Chronic Low Back Pain

Report of the NIH Task Force on Research Standards for Chronic Low Back Pain

Despite rapidly increasing intervention, func- tional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients’ lives. Such cLBP is often termed non-specific, and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, defini- tions, baseline assessments, and outcome mea- sures, which impede comparisons and consensus. The NIH Pain Consortium therefore charged a Research Task Force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research participants (drawing heavily on the PROMIS methodology); reporting “responder analyses” in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved the recom- mendations, which investigators should incorpo- rate into NIH grant proposals. The RTF believes these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of chronic low back pain. We expect the RTF recommendations will become a dynamic document, and undergo con- tinual improvement.
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Appropriation of the ‘Witch’ Stigma as White Women's Self-Empowerment

Appropriation of the ‘Witch’ Stigma as White Women's Self-Empowerment

With no missed appointments or rescheduling, the study should have been completed in 112 days. Completion of the study protocol took on average 123 ± 21 days and no statistically significant differences were observed between groups among protocol completers (124 days for intervention group, 121 days for control group, p=0.54, Table 4.1). Evaluation of medical records at baseline was conducted of comorbid diagnoses as possible confounders (Table 4.2) however there were no statistically significant differences in comorbid diseases between the groups. Baseline scores for pain interference, depression (BDI), and race were statistically significantly different between groups. Further analysis was conducted among those who completed the study relative to those who were lost-to-follow-up (LTF). Of the 85 participants in the study, 9 were still active at the time of this analysis, 50 completed the study, and 26 were LTF. The 9 active participants were removed from completion status analysis. Among those who completed the study, the average age in years was 57±9.9 compared to those who were LTF were 50±11.6 (p=0.01, Table 4.14). No other differences in demographics or comorbidities were found between those who completed the study and those who were LTF.
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Effectiveness of fixed-site high-frequency transcutaneous electrical nerve stimulation in chronic pain: a large-scale, observational study

Effectiveness of fixed-site high-frequency transcutaneous electrical nerve stimulation in chronic pain: a large-scale, observational study

A key finding from this study is the positive association between FS-TENS utilization and effectiveness. The baseline to follow-up improvement in all pain measures increased with higher device utilization. The number of subjects meeting the responder definition for pain interference with activity (33 vs 47%) and mood (25 vs 52%) increased substantially when comparing the low- and high-utilization subgroups. The proportion of subjects with a clinically important reduction in pain interference with activity or mood increased from 38 to 57%. Similarly, the pain intensity responder rate increased from 18% in the low-utilization subgroup to 33% of subjects in the high-utilization subgroup. FS-TENS utilization was determined by the subject rather than controlled. One expla- nation for this result is the existence of a causal link between FS-TENS dose and effectiveness. Another explanation is that users who benefited from FS-TENS, due to specific or nonspecific mechanisms, used it more often. In either case, it appears that daily, as opposed to intermittent, FS-TENS use provides individuals with chronic pain with the greatest likelihood of meaningful clinical benefit.
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Measuring the impact of trigeminal neuralgia pain: the Penn Facial Pain Scale-Revised

Measuring the impact of trigeminal neuralgia pain: the Penn Facial Pain Scale-Revised

Sound outcome measures are needed to assess the impact of new treatment interventions in clinical practice and research. The current research built upon previous work with the Penn- FPS and supported the development of a new stand-alone TN outcome measure with established content validity. This research confirms that the new 12-item Penn-FPS-R is easily understood and completed by individuals with TN, and fur- ther, that it captures all important concepts related to TN pain interference on HRQoL and daily functioning. Interviews

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Health-related quality of life and its socio-economic and cultural predictors among advanced cancer patients: evidence from the APPROACH cross-sectional survey in Hyderabad-India

Health-related quality of life and its socio-economic and cultural predictors among advanced cancer patients: evidence from the APPROACH cross-sectional survey in Hyderabad-India

We investigated HRQoL outcomes of stage 4 cancer pa- tients in a regional hospital in India and their predictors. Advanced cancer patients in our sample reported low physical, functional, emotional, social/family, and spirit- ual well-being, and experienced borderline depression. This was especially the case for those with lower finan- cial well-being and belonging to minority religions. Mar- ried women also reported lower social/family well-being. Additionally, pain interference and pain severity were as- sociated with almost all domains of HRQoL. Future re- search should be directed at improving HRQoL of advanced cancer patients, and especially those as identi- fied by our study as most vulnerable, including those with financial distress, minority religions, and married women. Future research should also assess the HRQoL experience of patients who are not aware of their cancer diagnosis or cognitively impaired.
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Responsiveness of the PROMIS® measures to changes in disease status among pediatric nephrotic syndrome patients: a Midwest pediatric nephrology consortium study

Responsiveness of the PROMIS® measures to changes in disease status among pediatric nephrotic syndrome patients: a Midwest pediatric nephrology consortium study

HRQOL is impacted in nephrotic syndrome by symp- toms related to the disease (edema), medications (e.g., corticosteroids, calcineurin inhibitors), and the unpre- dictable relapsing-remitting nature of the disease [2, 3]. Although cross-sectional evaluations have shown that NS adversely impacts HRQOL in physical, social, and emotional domains [2–4], there is an absence of pub- lished data about the longitudinal trends in HRQOL in this population. The NIH Sponsored Patient-Reported Outcomes Measurement Information System® (PROMIS®) has expanded our ability to measure and describe the HRQOL in children with chronic disease by creating mea- sures that are efficient, precise, and valid across a variety of diseases to assess patient-reported outcomes (PROs) (www.HealthMeasures.net) [5–9]. Pediatric nephrotic syn- drome has been incorporated as one of the exemplar chronic conditions in the initial PROMIS I and PROMIS II validation studies [10]. The initial PROMIS validation work in pediatric nephrotic syndrome showed the mea- sures were associated with disease status. Specifically, chil- dren with active nephrotic syndrome (i.e., presence of edema) had more Fatigue, Pain Interference, and Anxiety and less Mobility than children with inactive disease [3]. In addition, work has shown that children with prevalent disease experience more Pain Interference and are less sat- isfied with their Peer Relationships than children with in- cident disease [11]. Furthermore, our previous work has shown that the PROMIS measures provide complimentary results to a legacy measure, PedsQL™ 4.0 Generic Scales (PedsQL), with important differences that likely reflect differences in measure content [12].
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PubMedCentral-PMC4675693.pdf

PubMedCentral-PMC4675693.pdf

The percentage of participants with moderate to severe pain at 6 weeks in our sample (50%; 95% CI 42%-58%) is similar to that for individuals age 18-65 years receiving care after an MVC from the same 8 sites (51%; 95% CI 48%-54%); 40 outcomes at subsequent time points for the younger cohort have not yet been reported. (Direct comparison of our results to other cohorts of younger adults experiencing an MVC is difficult because these other studies restrict their samples to patients with initial pain symptoms. 41 ) In addition to indicating that rates of persistent pain in younger and older adults are similar, our findings suggest that the problem of persistent pain after an MVC in older adults is not just a problem of persistent neck pain. Among younger adults, MVC-related pain in either the neck or back (i.e. axial pain) is associated with pain interference with function. 40 Our findings suggest that in older adults acute pain in the lower extremities is also associated with persistent pain and pain interference. In contrast, chest pain at the time of the ED evaluation is common among older adults experiencing MVC, 42 but was infrequently reported at follow-up and was not strongly associated with either pain or pain interference with function at 6 months. Some of the participants with chest pain likely had radiographically occult rib fractures. Although often very painful in the acute phase, our findings suggest that these rib injuries do not usually result in persistent pain.
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6b2aa142e64c3a9fdf75a137c074e14865975b3f.pdf

6b2aa142e64c3a9fdf75a137c074e14865975b3f.pdf

question used the context statement “In the past 7 days.” Responses included 5 options ranging from “never” to “almost always” in the majority of domains and from “with no trouble” to “not able to do” for the Mobility measure. Each PROMIS Pediatric measure generates a T-score (mean = 50, standard deviation (SD) = 10 in the calibration population) [6]. Higher scores indicate higher levels of the trait that is being measured (i.e., higher scores signify worse Depression, Anxiety, Fatigue, and Pain Interference, and better functioning for Mobility and Peer Relationships). Administration time for all PROMIS measures using CAT was ap- proximately six minutes.
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Adaptation of a Brazilian Version of the North/Northeast Region for the Brief Pain Inventory

Adaptation of a Brazilian Version of the North/Northeast Region for the Brief Pain Inventory

The exploratory factorial analysis utilized in the study is similar to the statis- tical techniques found in other versions, with the intent of validating the BPI-B. The number of identified dimensions on previous psychometric tests was of two or three. Some studies have identified two factors: pain intensity and pain inter- ference [14] [21] [22] [23] [25] [28] [29]. In counterpart the studies of Saxena et al., (1999) [24] in India; Klepstad et al. (2002) [26] in Norway and Chaudakshe- trin (2009) [32] in Thailand, identified three factors: pain intensity, pain interfe- rence on routine and pain interference on emotion. These same factors were confirmed in this study. The difference of the factor model may have been caused by the conceptual alteration of the item on the translation period. The multidimensional scale, however, eliminates the effects of a general answer about standardization of the pain index with other countries, by means of simi- litude distinction of physical and psychological dimensions in different languag- es [7] [9] [16].
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