1. CLINICAL PAIN MEASUREMENT METHODS Z. TURK, D. ČELAN, A. AMMER UKC MARIBOR, Institute of Physical and Rehabilitation Medicine

2. SEDARE DOLOREM DIVINUM EST DOLOMETERALGOMETER?

3. Pain evaluation through centuries: sadness, joy, suffering, torture, bluffing, etc. PAIN IS INFORMATION PROVIDED BY THE PATIENT – INJURED PERSON AND EVALUATED BY A THERAPIST

4. PAIN CAN BE: PHYSICAL PSYCHOLOGICAL PSYCHOGENIC SOCIAL COGNITIVE EMOTIONAL SENSITIVE FUNCTIONAL MOTIVATIONAL

5. MEASUREMENTMETHODS Descriptive terms (no pain, mild, moderate, severe pain)‏ Numeric (0 to 10)‏ DescriptiveVisual Questionnaires and Instrumental measurement (laser, EMG, clinical measurement)‏

6. Visual scales VAS (visual analogue scale)‏ Different forms – numbers, images, contacts, for the purpose of analyzing results UNIT FOR MEASURING PAIN – PAIN INTENSITY ???

7. ALGORITHM - BONICA ACUTE PAIN (duration, intensity,,measuring methods -VAS, numeric scales)‏ CHRONIC PAIN (visual, verbal, numeric, questionnaires, psychosocial tests)‏

8. CLINICAL EXAMINATION Inspection SKIN: perspiration, color, sensitivity, spasticity, formSKIN: perspiration, color, sensitivity, spasticity, formPalpation Pressure, kneading, compression (algometer, dolometer)‏Pressure, kneading, compression (algometer, dolometer)‏ Neurological examinations Neurophysiological examinations (EMG)‏ Laser measurements

9. ALGOMETER

10. MEASURE PAIN INTENSITY Pain is what the patient reports Belive the patient Measure and systematically record

11. PAIN MEASUREMENT METHODS Descriptive Terms –No pain, Mild, Moderate, Severe Numerical Scores –Number 0 through10 Faces Scales Visual Analogue Multidimensional Instruments –McGill Pain Questionnaire

12. PALM PILOT - PAIN METER Palm top computer Measures 4 dimensions –Pain Intensity –Pain Relief –Mood –Side Effects One composite score from 0 to 10

13. 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

14. PRN Pain Treatment Cycle Patient Sleeps Patient Awakes Patient Has Pain Cals Nurse Evaluates Signs Out Medication Prepares Injection Gives Injection Medication Absorbed Pain is Relleved

15. PAIN DIMENSIONS Social & Cultural Experiences Tissue Damage Emotions & Motivation Cognitive Conceptual Past Experiences, Current, Espectation, Secondary Gain,Loss, Threat Perception Epression, Fear, Anger, Arousal & Behavioural Adaptations PAIN

16. Medical Care Psychological Support Social Services Vocational Rehabilitation Clinical Pharmacology MULTI- DISCIPLINARY PAIN TEAM PATIENT

17. ALGOLOGIST – WHO IS THIS?

18. PAIN TREATMENT SYMPTOMATICPATHOPHYSIOLOGICAL

19. Spend nice autumn days in Slovenia!