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895 ASSESSMENT OF PAIN AND QUALITY OF LIFE RELATIONSHIP IN PATIENTS WITH RHEUMATOID ARTHRITIS
S232
European Journal of Pain 2006, Vol 10 (suppl S1)
F30 OTHER 895 ASSESSMENT OF PAIN AND QUALITY OF LIFE RELATIONSHIP IN PATIENTS WITH RHEUMATOID ARTHRITIS A.N. Bardak ° , B. Erhan, B. Kaya, C. ¸ Dere, S. Ersoy. 70 Ys, Istanbul Fizik Tedavi Ve Rehabilitasyon E˘gitim Ve Ara¸stırma Hastanesi, Istanbul, Turkey Objective: Rheumatoid arthritis (RA) is characterized by pain, morning stiffness, fatigue, deformity of joints, limitation of motion and physical disability. The aim of this study is to evaluate the association between pain and quality of life (QOL) in patients with RA. Material and Methods: Twenty four patients (22 female, 2 male) who were diagnosed as RA were included in the study. Demographic data, duration of disease, use of medication were recorded. We measured activity of disease by DAS 28. Health Assessment Questionnaire (HAQ) was used to evaluate functional status. We evaluated quality of life by Short Form-36 (SF-36) and pain by Visual Analog Scale (VAS). Results: The mean age was 52.96±13.23 years, the mean duration of disease was 131.71±96.73 months. The mean VAS score was 5.75±2.79, the mean HAQ score was 1.59 ±0.52, the mean DAS 28 was 4.14±1.21. The mean physical, mental and total scores of SF-36 were 34.04±19.33, 37.31±19.68, 35.00±19.38 respectively. There was not a significant association between VAS and duration of disease. There was a significant positive correlation between DAS 28 and VAS (p < 0.001). A negative correlation was found between VAS and physical (p < 0.003), mental (p < 0.005) and total scores (p < 0.003) of SF36. We found a positive correlation between HAQ and VAS (p < 0.000). Conclusion: According to our study, RA patients having higher disease activity have more pain and as pain increases functional capacity decreases. This effects the patients’ QOL in a negative manner.
Abstracts, 5th EFIC Congress, Free Presentations 897 THE FUNCTION OF PSYCHOLOGICAL EXAMINATION OF PATIENTS INDICATED IN NEUROMODULATION TREATMENT H. Neudertova1 ° , M. Hakl2 , R. Hrib2 , P. Sevcik3 , O. Haklova3 . of Clinical Psychology, St. Anne’s Faculty Hospital in Brno, 2 Pain Management Center, St. Anne’s Faculty Hospital in Brno, 3 Department of Anastesiology and Intensive Care Medicine, Faculty Hospital Brno, Czech Republic 1 Department
Background: In the Czech Republic there are eight required preimplantation examinations, one of them being psychological. Methods: In our Center for the treatment of chronic pain, twenty-one psychological examinations were executed. Thirteen patients were prescribed neuromodulation treatment and eight of them were denied for various contraindicative reasons. The treatment demonstrably failed only one of the thirteen patients recommended for treatment. The treatment has been effective in reducing the intensity of pain to such level that the patient quality of life is increased significantly. The major part of the complex psychological examination process focuses on the observation of personality structure and its dynamics. We follow the level of developed pain behavior and the quality of developed adaptive coping strategies. We take into consideration the patients emotional state; the patients pain related behavior and also the advancement of related affective and neurotic disease, which without question relates directly to the problem of chronic pain. We confirm the occurrence of psychotic symptoms, dementia, hystrion strait, conversion mechanism, learned helplessness and secondary benefits. We consider serious psychological diseases, psychiatric illness and non-curative drug dependence or disposition to the development of any dependence as a significant contraindication. Results: In five years of observation we can say that the success of our psychological examinations is 92%. According to this gained result we consider the presence of psychological examinations in terms of various specialist examinations as important and highly effective.
896 PATIENT ASSESSMENT OF POSTOPERATIVE PAIN MANAGEMENT
Topic G: DIAGNOSIS, ASSESSMENT AND REVIEWS
A. Gomes1 ° , J. Mour˜ao1 , T. Bessa1 , S. Quevedo1 , L.F. Azevedo2 . de Anestesiologia/HSJo˜ao, Porto, 2 Servi¸co de Bioestat´ıstica e Inform´atica M´edica, FMUP, Porto, Portugal
G01 ASSESSMENT IN NONVERBAL POPULATIONS (INFANTS, MENTALLY IMPAIRED, ETC)
1 Servi¸ co
Background and Aims: The purpose of this pilot study was to describe postoperative pain management (PM), patient expectations and satisfaction, as part of a project aiming to validate acute pain assessment instruments and organize an acute PM unit at a university hospital in Portugal. Methods: Descriptive observational study with application of the acute pain management quality assessment survey. A sample of 137 postoperative patients was enrolled, from April 2004 to May 2005, and the questionnaire applied 24 to 48h after surgery. Results: Mean age was 51 years, 68% female. Type of surgery was gynecological (22%), abdominal (21%), plastic surgery (21%) or other (36%). Only 13% received any explanation about postoperative PM. Most frequent primary analgesia modalities were IV continuous infusion (62%), IV bolus (24%) and epidural bolus (7%). Pain rating at interview had median of 3 (IQR = 4) and the worst pain in the previous 24h had median of 8 (IQR = 5). 37% reported moderate to severe pain more than often. 66% had interference with normal daily activities. 23% agreed with the sentence “I never had a good pain relief ”. 14% of patients were not satisfied with their pain relief and 53% agreed that it could have been improved. Conclusions: An important number of patients experienced significant pain during the postoperative period, but this does not correlate with a corresponding low satisfaction. This study may provide support for the effectiveness of an acute PM unit in our hospital and provide important information on the validity of the APS quality standards.
898 DEVELOPMENT OF AN ACUTE PAIN BEHAVIORAL ASSESSMENT SCALE FOR ELDERLY WITH LIMITED COMMUNICATION ABILITY: ALGOPLUS P.R. Rat1 ° , E. Jouve2 , L. Nguyen3 , C. Zeller4 , M. Michel5 , F. Gauquelin6 , S. Chapiro7 , S. Bonin-Guillaume1 , C.O.L. Doloplus8 . 1 Service de M´ edecine Interne CHU-NORD AP-HM, Marseille, 2 CPCET CHU-TIMONE AP-HM Marseille, 3 SAU HOTEL-DIEU AP-HP Paris, 4 SAU CHU-NORD AP-HM Marseille, 5 Service de M´ edecine des Personnes aˆ g´ees CHU Rennes, 6 Equipe Mobile de Soins Palliatifs Ch Blois, 7 Hˆopital Paul Brousse AP-HP Paris, 8 Centre de Soins Palliatifs CHR Metz-Thionville, France Introduction: Cognitively impaired old patients suffering from Acute Pain (AP) are generally under treated. One explanation of this problematic situation is the lack of pain assessment scale adapted to the use in this population. Aim of investigation: Developing a short clinical useful behavioral scale for assessing AP in cognitively impaired elders. The second three studies of our program is to select the best ten items from the 48 items Algoplus Scale constructed at the end of the first study (published in Sydney 11th World Congress on Pain). Methods: This multicentric study included over 240 painful and non painful old patients. The understanding of Algoplus 48 items by the medical and nurses staff was first tested. Breath and heart rates were scored for all patients; medical practitioners or nurses interpreted the patient expressions as being painful or not, then Algoplus 48 was scored with
European Journal of Pain 2006, Vol 10 (suppl S1)
F30 OTHER 895 ASSESSMENT OF PAIN AND QUALITY OF LIFE RELATIONSHIP IN PATIENTS WITH RHEUMATOID ARTHRITIS A.N. Bardak ° , B. Erhan, B. Kaya, C. ¸ Dere, S. Ersoy. 70 Ys, Istanbul Fizik Tedavi Ve Rehabilitasyon E˘gitim Ve Ara¸stırma Hastanesi, Istanbul, Turkey Objective: Rheumatoid arthritis (RA) is characterized by pain, morning stiffness, fatigue, deformity of joints, limitation of motion and physical disability. The aim of this study is to evaluate the association between pain and quality of life (QOL) in patients with RA. Material and Methods: Twenty four patients (22 female, 2 male) who were diagnosed as RA were included in the study. Demographic data, duration of disease, use of medication were recorded. We measured activity of disease by DAS 28. Health Assessment Questionnaire (HAQ) was used to evaluate functional status. We evaluated quality of life by Short Form-36 (SF-36) and pain by Visual Analog Scale (VAS). Results: The mean age was 52.96±13.23 years, the mean duration of disease was 131.71±96.73 months. The mean VAS score was 5.75±2.79, the mean HAQ score was 1.59 ±0.52, the mean DAS 28 was 4.14±1.21. The mean physical, mental and total scores of SF-36 were 34.04±19.33, 37.31±19.68, 35.00±19.38 respectively. There was not a significant association between VAS and duration of disease. There was a significant positive correlation between DAS 28 and VAS (p < 0.001). A negative correlation was found between VAS and physical (p < 0.003), mental (p < 0.005) and total scores (p < 0.003) of SF36. We found a positive correlation between HAQ and VAS (p < 0.000). Conclusion: According to our study, RA patients having higher disease activity have more pain and as pain increases functional capacity decreases. This effects the patients’ QOL in a negative manner.
Abstracts, 5th EFIC Congress, Free Presentations 897 THE FUNCTION OF PSYCHOLOGICAL EXAMINATION OF PATIENTS INDICATED IN NEUROMODULATION TREATMENT H. Neudertova1 ° , M. Hakl2 , R. Hrib2 , P. Sevcik3 , O. Haklova3 . of Clinical Psychology, St. Anne’s Faculty Hospital in Brno, 2 Pain Management Center, St. Anne’s Faculty Hospital in Brno, 3 Department of Anastesiology and Intensive Care Medicine, Faculty Hospital Brno, Czech Republic 1 Department
Background: In the Czech Republic there are eight required preimplantation examinations, one of them being psychological. Methods: In our Center for the treatment of chronic pain, twenty-one psychological examinations were executed. Thirteen patients were prescribed neuromodulation treatment and eight of them were denied for various contraindicative reasons. The treatment demonstrably failed only one of the thirteen patients recommended for treatment. The treatment has been effective in reducing the intensity of pain to such level that the patient quality of life is increased significantly. The major part of the complex psychological examination process focuses on the observation of personality structure and its dynamics. We follow the level of developed pain behavior and the quality of developed adaptive coping strategies. We take into consideration the patients emotional state; the patients pain related behavior and also the advancement of related affective and neurotic disease, which without question relates directly to the problem of chronic pain. We confirm the occurrence of psychotic symptoms, dementia, hystrion strait, conversion mechanism, learned helplessness and secondary benefits. We consider serious psychological diseases, psychiatric illness and non-curative drug dependence or disposition to the development of any dependence as a significant contraindication. Results: In five years of observation we can say that the success of our psychological examinations is 92%. According to this gained result we consider the presence of psychological examinations in terms of various specialist examinations as important and highly effective.
896 PATIENT ASSESSMENT OF POSTOPERATIVE PAIN MANAGEMENT
Topic G: DIAGNOSIS, ASSESSMENT AND REVIEWS
A. Gomes1 ° , J. Mour˜ao1 , T. Bessa1 , S. Quevedo1 , L.F. Azevedo2 . de Anestesiologia/HSJo˜ao, Porto, 2 Servi¸co de Bioestat´ıstica e Inform´atica M´edica, FMUP, Porto, Portugal
G01 ASSESSMENT IN NONVERBAL POPULATIONS (INFANTS, MENTALLY IMPAIRED, ETC)
1 Servi¸ co
Background and Aims: The purpose of this pilot study was to describe postoperative pain management (PM), patient expectations and satisfaction, as part of a project aiming to validate acute pain assessment instruments and organize an acute PM unit at a university hospital in Portugal. Methods: Descriptive observational study with application of the acute pain management quality assessment survey. A sample of 137 postoperative patients was enrolled, from April 2004 to May 2005, and the questionnaire applied 24 to 48h after surgery. Results: Mean age was 51 years, 68% female. Type of surgery was gynecological (22%), abdominal (21%), plastic surgery (21%) or other (36%). Only 13% received any explanation about postoperative PM. Most frequent primary analgesia modalities were IV continuous infusion (62%), IV bolus (24%) and epidural bolus (7%). Pain rating at interview had median of 3 (IQR = 4) and the worst pain in the previous 24h had median of 8 (IQR = 5). 37% reported moderate to severe pain more than often. 66% had interference with normal daily activities. 23% agreed with the sentence “I never had a good pain relief ”. 14% of patients were not satisfied with their pain relief and 53% agreed that it could have been improved. Conclusions: An important number of patients experienced significant pain during the postoperative period, but this does not correlate with a corresponding low satisfaction. This study may provide support for the effectiveness of an acute PM unit in our hospital and provide important information on the validity of the APS quality standards.
898 DEVELOPMENT OF AN ACUTE PAIN BEHAVIORAL ASSESSMENT SCALE FOR ELDERLY WITH LIMITED COMMUNICATION ABILITY: ALGOPLUS P.R. Rat1 ° , E. Jouve2 , L. Nguyen3 , C. Zeller4 , M. Michel5 , F. Gauquelin6 , S. Chapiro7 , S. Bonin-Guillaume1 , C.O.L. Doloplus8 . 1 Service de M´ edecine Interne CHU-NORD AP-HM, Marseille, 2 CPCET CHU-TIMONE AP-HM Marseille, 3 SAU HOTEL-DIEU AP-HP Paris, 4 SAU CHU-NORD AP-HM Marseille, 5 Service de M´ edecine des Personnes aˆ g´ees CHU Rennes, 6 Equipe Mobile de Soins Palliatifs Ch Blois, 7 Hˆopital Paul Brousse AP-HP Paris, 8 Centre de Soins Palliatifs CHR Metz-Thionville, France Introduction: Cognitively impaired old patients suffering from Acute Pain (AP) are generally under treated. One explanation of this problematic situation is the lack of pain assessment scale adapted to the use in this population. Aim of investigation: Developing a short clinical useful behavioral scale for assessing AP in cognitively impaired elders. The second three studies of our program is to select the best ten items from the 48 items Algoplus Scale constructed at the end of the first study (published in Sydney 11th World Congress on Pain). Methods: This multicentric study included over 240 painful and non painful old patients. The understanding of Algoplus 48 items by the medical and nurses staff was first tested. Breath and heart rates were scored for all patients; medical practitioners or nurses interpreted the patient expressions as being painful or not, then Algoplus 48 was scored with