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Treatment outcome: subjective vs. objective measures of success as a function of mmpi personality profiles
176 Slide T.REATMEZTOUTCOME: SUBJECTIVE VS. ORJECTIVE MEASURES OF Sun 2:30 SUCCEZS AS A FUNCTION OF MMPI PERSONALI?"I' PROFILES. G. B. III i. ._ _~_~~~ ~~_~_..~__ J Powel, J Teague*, and C Freeman. (Span: J Powel) Painter : Swedish Hosp. Seattle Washington 90104 USA s Measures of success of inpatient multidisciplinary pain clinic treatment were examined as a function of personality profiles. While return to work and many subjective indices frequently cast a dismal light on treatment efficacy, some behavioral indices suggested a more favorable outcome. Full body range of motion, mobility, and strength scores comparably scaled and summated were included as dependent measures with objective characteristics. Methods: 50 patients serially admitted to an inpatient treatment progrdlrl for chronic pain were, prior to treatment, interviewed, administered the MMPI, and asked to fill out a questionnaire on impact of pain. A physical therapist obtained full body range of motion, mobility, and strength scores at weeks 1,3,7 and month six. Six month follow-up questionnaire data were also obtained. Results: Repeated measures analyses on the summated range of motion and wn scores suggested significant and durable improvement independent of personality profile tYypes.llHowever, subjective measures demonstrated a greater relations'hipto personality. Conclusion: The utility of contrasting subjective and objective criterion veriables was discussed.
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177 Slide II THERRPEUTIC INDEX FOR CHRONIC PAIN. P.J.D.Evms, D.R.Justins I, Sun 2:45 Departlent of Inaesthetics, Chtring Cross Hospital, London. U.K. 1. Oepartrent of dnresthetics St.Thonas’s Hospital London. U.K. II1 fiII(, The abstract nature of chronic pain rakes #easurement difficult. Without relia “G. I ec P*nrquesfor analysing changes in pain severity the critical evaluation of results ray prove meaningless. The fluctuation in pain intensity and the variable duration of syrptoas nakes standard pain assessrent proceedures inappropriate. In order to provide a framework fron which to plan projected lines of The intention is not to provide therapy a new approach to evaluating therapy has been adopted. quantitative data but to provide a qualitative index for all therapies. It should then be possible to evaluate new therapy using the same criteria and with reference to past performance. WIJ 111 patients attending the Pain Relief Clinic and receiving treatlent have their progress RI1 observations are made by the physician in charge. The omission assessed using a standard scale. of a quatitative score reduced the effect of observer bias. 1 = No patient benefit but no side effects. 0 - Therapy made patient feel worse. 2 = No patient benefit but an aid to diagnosis. 3 = Short terr gain - upto 4E hours, 5 = Long tera gain - more than two ronths. 4 = Hoderate gain - more than 2 reeks. 6 = Cure - patient discharged from care. Rnalysis of over 1000 treatrents gave the folloring prcliainary findings. Less than 7% REX& of patients were completely relieved of pain and discharged free the clinic. Non invasive therapy such as acupuncture, relaxation therapy and TENS proved the lost effective forms of treatment. Drugs local anaesthetic injections and neurolytic blocks and invasive therapy such as epidural blocks, indicated that fee patients gained long were equally effective although the low scores recorded, neurolytic injections performed to relieve the pain of cancer tern benefit. Of individual therapy, proved highly effective although the short duration of life of these patients limited the information on long terr gains. @&l,l&& The use of a continuous and prospective analysis of therapy should prove useful in forward planning and perhaps help to reduce the complications frequently associated with pain therapy. It should also provide a lore realistic appraisal of the true value of individual fores of treatrent.
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177 Slide II THERRPEUTIC INDEX FOR CHRONIC PAIN. P.J.D.Evms, D.R.Justins I, Sun 2:45 Departlent of Inaesthetics, Chtring Cross Hospital, London. U.K. 1. Oepartrent of dnresthetics St.Thonas’s Hospital London. U.K. II1 fiII(, The abstract nature of chronic pain rakes #easurement difficult. Without relia “G. I ec P*nrquesfor analysing changes in pain severity the critical evaluation of results ray prove meaningless. The fluctuation in pain intensity and the variable duration of syrptoas nakes standard pain assessrent proceedures inappropriate. In order to provide a framework fron which to plan projected lines of The intention is not to provide therapy a new approach to evaluating therapy has been adopted. quantitative data but to provide a qualitative index for all therapies. It should then be possible to evaluate new therapy using the same criteria and with reference to past performance. WIJ 111 patients attending the Pain Relief Clinic and receiving treatlent have their progress RI1 observations are made by the physician in charge. The omission assessed using a standard scale. of a quatitative score reduced the effect of observer bias. 1 = No patient benefit but no side effects. 0 - Therapy made patient feel worse. 2 = No patient benefit but an aid to diagnosis. 3 = Short terr gain - upto 4E hours, 5 = Long tera gain - more than two ronths. 4 = Hoderate gain - more than 2 reeks. 6 = Cure - patient discharged from care. Rnalysis of over 1000 treatrents gave the folloring prcliainary findings. Less than 7% REX& of patients were completely relieved of pain and discharged free the clinic. Non invasive therapy such as acupuncture, relaxation therapy and TENS proved the lost effective forms of treatment. Drugs local anaesthetic injections and neurolytic blocks and invasive therapy such as epidural blocks, indicated that fee patients gained long were equally effective although the low scores recorded, neurolytic injections performed to relieve the pain of cancer tern benefit. Of individual therapy, proved highly effective although the short duration of life of these patients limited the information on long terr gains. @&l,l&& The use of a continuous and prospective analysis of therapy should prove useful in forward planning and perhaps help to reduce the complications frequently associated with pain therapy. It should also provide a lore realistic appraisal of the true value of individual fores of treatrent.
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