Pain of OT view points

1.職能治療師對於疼痛的介入,不僅僅從生理的角度去評估病患,也同時從情緒及認知等方面著手.
2.職能治療師認為病患對於慢性疼痛的反應,可藉對疼痛機制的了解而有所改變
3.職能治療師相信,個體強大的態度和信念價值體系,足以衝擊影響患者如何看待自己以及適應能力
4.對於尋找職能治療解決疼痛的患者而言,很重要的功課是必需要先很清楚的知道,本身希望尋求解決的問題到底是什麼

http://www.aota.org/Consumers/Professionals/WhatIsOT/PA/Articles/Chronic-Pain.aspx




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https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad=rja&ved=0CEoQFjAC&url=http%3A%2F%2Fwww.aota.org%2Fconsumers%2Fconsumers%2Fhealth-and-wellness%2Fpain%2F35137.aspx&ei=SH7UUNzoFsfIhAfF-oHwBA&usg=AFQjCNHJkOx13cQBF-rOO7gZIIDcbAwI7g&sig2=elE_4_s8fM_EZof_eGGBiA

疼痛網站搜集

台灣家庭醫學醫學會 http://www.tafm.org.tw/Data/011/77/180203.htm

American Pain Foundation

Stanford University School of Medicine: Chronic Pain

International Association for the Study of Pain

AOTA’s Chronic Pain Tip Sheet





詞彙網站

British National Corpus (BNC) l

metaphor

疼痛描述工具的臨床價值

1.疼痛描述工具被使用描述病徵、區辨不同的診斷(distinguishing between diagnoses)，預測治療成效及反應以及偵測治療反應(predicting treatment outcome and other symptoms, and detecting treatment effects)

Ref: in Introduction_The journal of pain,7(11),2006: 823-32

2.疼痛描述工具在疼痛機制的研究上佔有重要地位

Ref:(待)

區別不同的診斷
比較罹患多發性硬化者症及脊髓損傷者，其描述疼痛形容詞不同。此外，脊髓損傷者描述損傷部位以下及以上的形容詞也不相同。

European Journal of Pain 15, 2011:628-33



預測治療成效
治療前的疼痛分數(Pre-treatment NPS-10)與治療成果(fatique量表成績)具有相關性


 Fishbain DA, Lewis J, Cole B, Cutler RB, Smets E, Rosomoff HL, Rosomoff RS: Multidisciplinary pain facility treatment outcome for pain-associated fatigue. Pain Med 6:299-304, 2005(引用22)

Pain Quality Assessment Score

The brevity of the NPS makes it useful in clinical and research settings in which assessment burden is a significant issue. However, a number of pain qualities that are common to persons with neuropathic and non-neuropathic pain are not assessed by the NPS. These include “electric,” “tingling” (or “pins and needles”), “radiating,” and “numb” qualities.2,4,5,6,24,36 The work of Bouhassira et al,4,5 in particular, has emphasized the importance of paresthesia as a critical component of neuropathic pain, and that patients can provide reliable and valid ratings of this component of neuropathic pain. Adding items that assess each of these qualities to the NPS should increase its content validity for assessing neuropathic pain. In addition, the utility of the measure could be improved further if it included pain qualities common to other pain conditions,6,36 such as a number of the pain quality domains included in more generic (ie, non–diagnosis-specific) measures (eg, the MPQ-SF).27

These include such qualities as “tender,” “shooting,” “cramping,” “throbbing,” “aching,” and “heavy.” We therefore added 10 descriptors to the NPS to increase its content validity for assessing neuropathic pain

and to make it useful for assessing non-neuropathic pain as well. The specific items added assessed tender, numb, electrical, tingling, radiating, throbbing, aching, shooting, cramping, and heavy pain qualities. Also, to improve the temporal item of the NPS, we provided more clear descriptions of the 3 temporal classifications of pain that this item was designed to assess. Because the resulting questionnaire could be used to assess both neuropathic and non-neuropathic pain, we removed the word neuropathic from the scale name and called the resulting 20-item measure the Pain Quality Assessment Scale (PQAS)

Neuropathic Pain Symptom Inventory

Each of these items was quantified on a (0–10) numerical scale.

Average spontaneous  pain  severity  during  the  past  24 h.

12 items

a list of descriptors reflecting spontaneous ongoing or paroxysmal pain, evoked pain (i.e. mechanical and thermal allodynia/hyperalgesia) and dysesthesia/paresthesia.

Neuropathic Pain Scale

Includes two items that assess (1) the global dimensions of  pain intensity  and  pain  unpleasurement and (2)eight  items of  specific neuropathic pain qualities  (“sharp,” “hot,” “dull,” “cold,” “sensitive,” “itchy,” “deep,” and  “surface” pain)

Each of the items includes a description and other similar descriptive words for that item. Each of the items has a 0 to 10 numerical score, in which 1 is “no” or “not” and 10 is “the most”

In additions, the scale also want to patients describe the time quality of pain (the background pain, break-through pain and occasional pain)

Multidimensional Affect and Pain Survey

In the MAPS questionnaire the descriptors are placed in sentences to clarify their meaning. The patient rates these statements on a response scale from not at all (0) to very much so (5).

Supercluster I, somatosensory pain qualities

17 subclusters

57 descriptors of painful sensory qualities

Supercluster II, emotional pain

Eight subclusters

26 descriptors of negative emotional qualities

Supercluster III, well-being

Fve subclusters

18 descriptors of positive affect and health

 

History:

The 101 items of MAPS were selected from earlier sets of 270 (Clark et al., 1995) and 189 (Yang et al., 2000) descriptors of pain and emotion. The similarities of the 189 descriptors were evaluated by 104 female and male college students of Puerto Rican, European–American and African–American descent. Each volunteer first sorted descriptors that she/he considered to be similar into piles. Following this pile-

sort procedure the volunteers merged their individual piles two at a time on the basis of similarity. This sequentialmerge procedure continued until only two piles remained.

The data were evaluated by an agglomerative, hierarchical clustering technique,    the Average-Linkage-Between-Groups algorithm (Sokal and Michener, 1958) to yield hierarchically organized clusters of descriptors that were similar in meaning, a dendrogram. Details of the development and validation of MAPS are presented elsewhere (Yang et al.,2000).The final set of 101 words used in MAPS included those

words  that  remained  after  eliminating  88  (of  the  189) descriptors that failed to have a common meaning among the  six  sex-ethnocultural  groups.  This  left  a  composite dendrogram of 101 words that was relatively free of gender and  ethnocultural  bias.  The structure  of  the  dendrogram

determined which descriptors fell within each cluster for MAPS as well as the location of the 30 subclusters within the three MAPS superclusters.