Measuring pain in the twentieth century: A study of methodologies
|
| Noble, Bill, The University of Sheffield, UK, Clark, David, The University of Lancaster, UK, Seymour, Jane, The University of Sheffield, UK, Winslow, Michelle, The University of Sheffield, UK, Meldrum, Marcia, The University of California, Los Angeles, USA |
Objective: To describe the range of methodologies used to measure pain in the twentieth century and relevance to current research practice.
Method: As part of a wider study which employed sociological, historical and ethical perspectives, a literature review covered peer-reviewed journals in cancer, palliative care, public health, medical history, medical sociology, and medical anthropology.
Results: Three paradigms of pain measurement were identified.:
1) psychophysics, dates back to the 19th century and may be used to detect analgesic effects by quantifying a noxious stimulus required to elicit pain; 2) descriptions of pain in many dimensions, including quality, intensity and emotional impact, emerged in the late 1930s and were subsequently the basis of tools such as the McGill Pain Questionnaire and Brief Pain Inventory; 3) simple measures of intensity of current pain using verbal or numerical rating scales were developed after 1948., used later together with visual analogue scales in clinical trials of analgesics.
Conclusion: The principles of psychophysics continue to be used in animal experiments to detect analgesic effects of new therapies. Pain questionnaires have contributed to clinical method and our understanding of the categories and mechanism of various pain states. Verbal and numerical pain scales have been used to transform the subjective experience of pain intensity into a parameter for the evaluation of therapies. Pain measurement using verbal scales has also emerged in clinical practice where pain has become the fifth vital sign.
|
