Browsing by Subject "Pain Measurement"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item Evaluation And Treatment Of A Heterogenous Group Of Chronic Pain Patients: Assessing The Effect Size Of Outcome Measures(2007-08-08) Worzer, Whitney; Stowell, Anna W.The aim of the present study was to evaluate an array of psychometric tests administered to a heterogeneous group of chronic pain patients at pre- and post- treatment to determine the effect sizes of the measures. The sample included patients (N=312) who participated in an interdisciplinary treatment program, which included medical, psychological, psychiatric, and physical therapy components. This sample was narrowed to include only those who completed treatment (n=262). Subjects were evaluated on a variety of physical/functional, psychosocial, and coping measures, including the Visual Analog Scale (VAS), Million Visual Analog Scale (MVAS), Oswestry Low Back Pain Disability Questionnaire (OSW), Pain Medication Questionnaire (PMQ), Medical Outcomes Survey 36-Item Short Form Health Survey (SF-36), Beck Depression Inventory-II (BDI-II), and Multidimensional Pain Inventory (MPI). Paired sample t-tests were conducted to evaluate each measure for pre- to post-treatment change. These measures were further analyzed using Cohen's d (1992) to obtain the effect size. Results indicated that the instruments showing the greatest effect size were the VAS (d= 1.27) and the MVAS (d=0.94), both within the large effect size range. The OSW (d=0.67) showed a medium effect size, while the SF-36/PCS (d=0.19) had the lowest effect size of the physical measures. Results indicated a medium effect size for psychosocial measures. The PMQ (d=0.79) BDI-II (d=0.72) and the SF-36/MCS (d=0.62). The MPI exhibited an extremely low effect size (d=0.03). The heterogeneous population was also broken down into three categories of pain diagnoses including musculoskeletal, all other single pain diagnoses (e.g. headache, neuropathy, reflex sympathetic dystrophy, firbomyalgia), and multiple diagnoses (more than one type of pain). Overall, this study offers information on the effect sizes of different measures in order to facilitate the decision making process when selecting assessment tools to use with chronic pain populations, and supports the use of multiple assessment measures.Item Multidimensional Pain Inventory: Revised Profile Classification Based on Clinical Observations in a Pain Setting(2005-08-11) Ravani, Payal Jitendra; Stowell, Anna WrightThe purpose of this study was to build a new profile classification system for the Multidimensional Pain Inventory (MPI). According to some clinical researchers, the current profiles of the MPI do not fully portray how chronic pain patients evaluate and manage their pain because of the great variability in each subgroup. This study tried to revise the current profile classifications based on clinical observations, which may then lead to facilitate improved patient assessment, professional communication, and treatment planning. Participants, who completed pre- and post- treatment MPI measures, were randomly selected from the interdisciplinary program at the Eugene McDermott Center for Pain Management at UT Southwestern Medical Center at Dallas. Two hundred and eighty patients were then assigned to three different groups depending upon the re-coded scores from their pre-treatment MPI. Patients were grouped according to their MPI subscale scores. In order to determine if the hypotheses were supported or not, paired t-test were completed on six different psychosocial and functional outcome measures. Analyses were also conducted to check for differences among the nine different groups. As postulated, a number of significant relationships were identified. Paired t-test analyses demonstrated the significance of the relationship between certain MPI subscales. When Pain Severity (PS) and Interference (I) were below average (as determined by recoded T scores), patients had a good prognosis. When Life Control (LC) equaled Affective Distress (AD), participants were seen to have a good prognosis as well. Associations between the other MPI subscales were also assessed, but data did not support those hypotheses. The majority of the outcomes did not meet expectation, because of several limitations with the study design.Item Predictors of Success Across Differing Interdiscilinary Pain Programs: Who Benefits from Which Treatment?(2009-09-04) Oslund, Sarah Renee; Robinson, Richard C.This study aimed to examine predictors of completion and success in interdisciplinary treatment for chronic pain and to provide clinicians with relevant information in determining the appropriate treatment intensity for patients. A total of 1,062 patients were examined who participated in one of three different levels of treatment intensity: a 120 hour treatment program (n=699), a 72 hour treatment program (n=61), and a 24 hour treatment program (n=302). Results indicated that higher levels of anxiety and greater number of visits to the emergency room in the twelve months prior to treatment were predictive of premature termination of treatment in the more intensive program. For less intensive programs, number of hours resting per day was predictive of early termination of treatment. Predictors of success were then examined utilizing five definitions of success. No single measure was found to be a significant predictor across all five domains. However, lower levels of health care utilization, higher levels of affective distress, greater perceived interference from pain, and lower levels of perceived control were predictive of successful outcomes. Overall, the findings indicate that individuals with greater dysfunction at treatment entry will benefit more from treatment. When comparing three programs of different intensities, the most intensive program produced a higher proportion of successful outcomes. Pre-treatment variables were explored as a means of identifying relevant clinical variables that could be utilized by clinicians to identify the most appropriate treatment program for patients. Greater number of hours resting and higher levels of pain at pre-treatment were found to be useful variables. Namely, those resting more than seven hours per day or reporting pain levels higher than six out of twelve indicated a need for the most intensive program.