A comparison of two pain measures for Asian American cancer patients

Prevalence, Severity, and Determinants of Pain in Thalassemia

As the life expectancy in thalassemia is improving, pain is being recognized as an emerging problem. To document the pain prevalence and severity in patients with transfusion-dependent thalassemia all transfusion-dependent thalassemia patients >10 years of age (n = 165) attending the Thalassemia Day Care Center were assessed for pain prevalence, severity, and its effect on various life activities using the Brief Pain Inventory. Their medical records were reviewed for the presence of various co-morbidities. Pain was reported by 62.4% of participants with 35.2% and 59.4% of participants, reporting pain in the past 1 and 4 weeks respectively. A significantly higher pain prevalence was reported in females (p = .037), patients residing in urban areas (p = .038), and employed participants (p = .038). The commonest sites of pain were the lower back and calves. General activity (p = .02) and enjoyment of life (p = .02) were significantly affected due to pain in patients between 21 and 30 years of age. Female participants reported interference of pain with mood (p = .03). A significant correlation of pain prevalence was found with higher average serum ferritin (p = .015), moderate to severe liver iron concentration (p = .04), and lower levels of 25 hydroxyvitamin D levels (p = .03). Pain is an emerging cause of morbidity in thalassemia. The study found a significant association of pain with modifiable factors such as serum ferritin, LIC, and 25 (OH) vitamin D levels.

Multidisciplinary management of metastatic spine disease: initial symptom-directed management

In the past 2 decades, a deeper understanding of the cancer molecular signature has resulted in longer longevity of cancer patients, hence a greater population, who potentially can develop metastatic disease. Spine metastases (SM) occur in up to 70% of cancer patients. Familiarizing ourselves with the key aspects of initial symptom-directed management is important to provide SM patients with the best patient-specific options. We will review key components of initial symptoms assessment such as pain, neurological symptoms, and spine stability. Radiographic evaluation of SM and its role in management will be reviewed. Nonsurgical treatment options are also presented and discussed, including percutaneous procedures, radiation, radiosurgery, and spine stereotactic body radiotherapy. The efforts of a multidisciplinary team will continue to ensure the best patient care as the landscape of cancer is constantly changing.

Consistency and Accuracy of Multiple Pain Scales Measured in Cancer Patients From Multiple Ethnic Groups

BACKGROUND

Standardized pain-intensity measurement across different tools would enable practitioners to have confidence in clinical decision making for pain management.

OBJECTIVES

The purpose was to examine the degree of agreement among unidimensional pain scales and to determine the accuracy of the multidimensional pain scales in the diagnosis of severe pain.

METHODS

A secondary analysis was performed. The sample included a convenience sample of 480 cancer patients recruited from both the Internet and community settings. Cancer pain was measured using the Verbal Descriptor Scale (VDS), the visual analog scale (VAS), the Faces Pain Scale (FPS), the McGill Pain Questionnaire-Short Form (MPQ-SF), and the Brief Pain Inventory-Short Form (BPI-SF). Data were analyzed using a multivariate analysis of variance and a receiver operating characteristic curve.

RESULTS

The agreement between the VDS and VAS was 77.25%, whereas the agreement was 71.88% and 71.60% between the VDS and FPS, and VAS and FPS, respectively. The MPQ-SF and BPI-SF yielded high accuracy in the diagnosis of severe pain. Cutoff points for severe pain were more than 8 for the MPQ-SF and more than 14 for the BPI-SF, which exhibited high sensitivity and relatively low specificity.

CONCLUSION

The study found substantial agreement between the unidimensional pain scales and high accuracy of the MPQ-SF and the BPI-SF in the diagnosis of severe pain.

IMPLICATIONS FOR PRACTICE

Use of 1 or more pain screening tools that have validated diagnostic accuracy and consistency will help classify pain effectively and subsequently promote optimal pain control in multiethnic groups of cancer patients.

The Influence of Social Structure on Cancer Pain and Quality of Life

The aim of this study was to investigate whether social structure is associated with cancer pain and quality of life using the Social Structure and Personality Research Framework. This study was a secondary analysis of data from 480 cancer patients. The measurements included socioeconomic variables, self-reported cancer pain using the McGill Pain Questionnaire–Short Form (MPQ-SF), and quality of life measured using the Functional Assessment of Cancer Therapy Scale (FACT-G). The data were analyzed using moderated multiple regression. Cancer pain and quality of life differed significantly with income. The associations between income and pain and quality of life were significant only for the high education group (≥ partial college), and these associations were greater for Caucasians than for their counterparts ( p < .05). When developing interventions, nurses should consider the influence of socioeconomic variables on pain and quality of life while considering possible moderating factors such as education.

Confirmatory factor analysis of the Korean version of the short-form McGill pain questionnaire with chronic pain patients: a comparison of alternative models

Background

The Short Form of the McGill Pain Questionnaire (SF-MPQ) is the most widely used assessment of the quality and intensity of pain. In previous validation studies, the factor structure of the SF-MPQ varied widely from various two-factor structures to a five-factor structure, although research on the SF-MPQ quite consistently supports its two-factor structure (i.e., sensory and affective) across different countries and languages. In Korea, the results of exploratory factor analysis of a Korea version of SF-MPQ (KSF-MPQ) showed 2-factor structure consisting of ‘sensory’ and ‘affective’ excluding two items such as splitting and heavy. As an attempt to further validate the KSF-MPQ, the purpose of this study was to confirm whether the KSF-MPQ model is an appropriate model for chronic pain patients in Korea by comparing several alternative models of the SF-MPQ.

Findings

A total of 150 chronic pain patients seeking treatment in Seoul, Korea, participated and completed the KSF-MPQ. Confirmatory factor analysis was conducted to evaluate the adequacy of the KSF-MPQ model and several alternative models. The results indicated that the adjusted KSF-MPQ model showed the best fit to the data among the models in chronic pain patients in Korea.

Conclusions

The results showed the KSF-MPQ is cross-culturally equivalent to the original questionnaire. Thus, the KSF-MPQ is valid measurement for assessing the quality and intensity of pain to chronic pain patients and may be helpful in clinical and research settings in Korea.