Patient tolerance of loxaglate and lopamidol in internal mammary artery arteriography

Factorial validity of the short-form McGill pain questionnaire (SF-MPQ)

Although widely used, there have been few investigations of the factorial validity of the short-form McGill Pain Questionnaire (SF-MPQ; Melzack, 1987). Confirmatory factor analysis was performed on item responses to the SF-MPQ obtained from 188 patients with chronic back pain. Consistent with the original structure proposed by Melzack (1987), results indicated that the SF-MPQ is best represented by a two-factor solution. However, these findings are contrary to results obtained by Burckhardt and Bjelle (1994) who, using their Swedish version of the SF-MPQ, obtained a three-factor solution. Potential explanations for the disparity between the results of the two studies are explored and recommendations for continuing clinical and research applications are offered.

Reliability and sensitivity measures of the Greek version of the short form of the McGill Pain Questionnaire

The translation of existing healthcare measurement scales is considered a feasible, efficient and popular approach to produce internationally comparable measures. The short form of the McGill Pain Questionnaire is one of the most widely used and translated instruments to measure the pain experience. The Greek version of the short form of the McGill Pain Questionnaire (GR-SFMPQ) has recently been developed and demonstrated satisfactory levels of internal consistency. The objective of the present study was to assess the instrument's reliability and sensitivity.Eighty patients with spinal or knee pain were included. The test-retest reliability of the instrument was estimated for measurements within the same day and after 15 days. The sensitivity of the measure was examined before and after the application of a physiotherapy therapeutic regime. The correlation coefficients (Intraclass Correlation Coefficient and Spearman's) ranged from 0.87-0.98 for within-day measurements and from 0.70-0.92 for administrations between days. All indexes of the GR-SFMPQ (total score, sensory and affective scores, total count of used words, visual analogue score, present pain index) managed consistently to detect the changes in pain experienced (p<0.05), after a therapeutic intervention, when assessing for the sensitivity of the questionnaire. An explorative discriminant analysis of the GR-SFMPQ indexes managed to correctly classify up to 85% of the patients; a classification rate comparable to the full version MPQ rating capacity. It can be argued from the results of this study that the Greek version of the SFMPQ fulfils the criteria of reliability and sensitivity to fluctuations of pain and can be utilized with confidence in cross-cultural comparative research trials.

The development and validation of a Greek version of the short-form McGill Pain Questionnaire

BACKGROUND

The short form of the McGill Pain Questionnaire (SFMPQ) is a widely used instrument for assessing the quality of pain where use of the full form is not possible. To date however, this instrument has not been translated into the Greek language.

AIMS

It is the aim of this study to validate an adopted Greek version of the short form of the McGill Pain Questionnaire.

METHODS

A systematic translation procedure was followed before development of the final version. Sixty spinal and osteoarthritis chronic musculoskeletal pain patients completed the questionnaire. A large percentage of the subjects (43%) was of elementary educational level.

RESULTS

The analysis of the results indicated that an internally consistent (Cronbach's alpha = 0.71) and content valid (all 15 descriptors were used at least by the 33% of the subjects) instrument has been developed. It has been shown to be suitable, easy to understand and administer for this sample of chronic musculoskeletal patients.

CONCLUSIONS

A Greek version of the SFMPQ (the GR-SFMPQ) has been constructed which has the properties of internal validity and consistency. It is easy to administer, easy to understand even for an elementary educational level and it is capable of describing multidimensionally the pain experience of chronic musculoskeletal pain patients.

Measurement of pain

Pain is a personal, subjective experience influenced by cultural learning, the meaning of the situation, attention, and other psychologic variables. Approaches to the measurement of pain include verbal and numeric self-rating scales, behavioral observation scales, and physiologic responses. The complex nature of the experience of pain suggests that measurements from these domains may not always show high concordance. Because pain is subjective, patients' self-reports provide the most valid measure of the experience. The VAS and the MPQ are probably the most frequently used self-rating instruments for the measurement of pain in clinical and research settings. The MPQ is designed to assess the multidimensional nature of pain experience and has been demonstrated to be a reliable, valid, and consistent measurement tool. A short-form MPQ is available for use in specific research settings when the time to obtain information from patients is limited and when more information than simply the intensity of pain is desired. The DDS was developed using sophisticated psychophysical techniques and was designed to measure separately the sensory and unpleasantness dimensions of pain. It has been shown to be a valid and reliable measurement of pain with ratio-scaling properties and has recently been used in a clinical setting. Behavioral approaches to the measurement of pain also provide valuable data. Further development and refinement of pain measurement techniques will lead to increasingly accurate tools with greater predictive powers.

Nonselective angiography of the internal mammary artery: a fast, reliable, and safe technique

Selective cannulation of the mammary artery can be time consuming and carries a risk of arterial injury. The nonselective technique described here is faster, safer, and as reliable as the standard selective technique. A consecutive series of patients with previous coronary artery bypass graft surgery (CABG) were randomized to undergo either selective or nonselective mammary artery angiography. Selective angiography was performed using the standard selective technique. Nonselective angiography was performed by placing a standard catheter in the subclavian artery and hand injecting 10 ml of contrast while inflating a blood pressure cuff 10 mm above the systolic pressure in the ipsilateral arm. Fifty-six patients were studied, 30 patients selectively, and 26 patients nonselectively. The time to visualize adequately both native and grafted mammary arteries in the selective group was 4.83 + 5.00 min and in the nonselective group 1.76 + 1.16 minutes (P = 0.006). A nonselective technique for visualizing the mammary artery is significantly faster and as reliable as the standard selective technique.