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Patients are, as the name might suggest,
very patient in filling in questionnaires and completing physical tests.
These tell us how the individual patient is doing at the beginning and
end of treatment and at follow-up, valuable information for the patient
and for the referrrer. But we also collect the data and examine it to
answer general questions about outcome
and specific questions such as work and drug use.
We also try to refine and shorten the measures themselves or the overall
burden of measures. We have completed research projects on physical performance
measures [Harding et al.]; on how patients arrive
at a number to represent pain intensity and pain distress [Williams
et al. 2001]; on depression and depressed mood [Williams
& Richardson 1993, Morley et al. 2002] and on a World Health Organisation
measure of quality of life [Skevington et al.].
Advice and commentary on methods of measuring outcome of chronic pain
treatment can be found in several papers and chapters [Williams
2001, Williams 1996, Williams 1999, Williams 2002] and a shortlist
of measures agreed at a consensus conference to be useful for pain management
programmes is at Appendix 1 of the Desirable Criteria new draft on the
Pain Society website (www.painsociety.org).
For those considering running trials or asking specific questions about
outcome, a further chapter on trial design [Morley &
Williams 2002] may be useful.
References
Harding VH, Williams ACdeC,
Richardson PH, Nicholas MK, Jackson JL, Richardson I, Pither CE (1994).
The development of a battery of measures for assessing physical functioning
of chronic pain patients. Pain 58 367-375.
Williams ACdeC, Davies HTO, Chadury Y (2001). Simple pain rating scales
hide complex idiosyncratic meanings. Pain 85, 457-463.
Williams ACdeC, Richardson PH (1993). What does the BDI measure in chronic
pain? Pain 55, 259-266.
Skevington SM, Carse MS, Williams ACdeC (2001) Validation of the WHOQOL-100:
pain management improves quality of life for chronic pain patients. Clinical
Journal of Pain 17, 264-275.
Williams ACdeC (2001) Outcome assessment in chronic non-cancer pain treatment.
Acta Anaesthesiological Scandinavica 45, 1076-1079.
Williams ACdeC (1996). Assessment of pain, psychological impact and disability.
In JN Campbell (ed.), Pain 1996 - an updated review. Seattle: IASP Press,
pp. 269-277.
Williams ACdeC (1999). Measures of function and psychology. In R Melzack
& PD Wall (eds.), Textbook of Pain, 4th edition. Edinburgh: Churchill
Livingstone, pp. 427-444.
Williams ACdeC (2002). Selecting and applying pain measures. In H Breivik,
W Campbell, C Eccleston (eds.), Clinical pain management: Practical applications
and procedures. London: Arnold Publications, pp. 3-14.
Morley S, Williams ACdeC (2002). Conducting and Evaluating Treatment Outcome
Studies. In DC Turk & R Gatchel (eds.), Psychological Approaches to
Pain Management: A Practitioners Handbook 2nd Edition. New York: Guilford
Press, pp. 52-68.
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