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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Relationships of patients' ethnicity to their reported pain, emotional distress and requests were investigated. When patients aged over 60 years were compared. Italian-Americans were found to more frequently report pain than were Anglo-Americans; however, this difference was not replicated in the younger patients of Italian and Anglo backgrounds. In addition to patients' age, their sex also was found to mediate the relationship of ethnicity to the expression of pain. In particular, older female Italian-Americans were likely to report pain while, in contrast, older male Anglo-Americans were not. Age and sex may be important mediators of ethnic differences because older and female patients may carry on ethnic traditions more than do younger and male patients. Ethnicity was not found to be significantly related to emotional distress and requests.
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PMID:Ethnicity in the reported pain, emotional distress and requests of medical outpatients. 671 Jan 89

Signal detection measures olfactory sensitivity (d') and measures of blood pressure, heart rate, body temperature, nasal airflow, and respiration rate were repeatedly established within approximately 2.5-hr test sessions held every other day across 17 menstrual cycles of women not taking oral contraceptives, 6 menstrual cycles of women taking oral contraceptives, and 6 equivalent time periods of three men. In addition, radioimmunoassay-determined serum levels of luteinizing hormone, follicle stimulating hormone, estrone, estradiol, progesterone, and testosterone, as well as responses to the Moos Menstrual Distress Questionnaire (MDQ), were established daily or bidaily throughout the study periods. Peaks in olfactory sensitivity were noted during the second half of menses, midcycle, and midluteally in women taking and in women not taking oral contraceptives. The lack of correlation between the fluctuations in d' and the circulating hormone levels in the group using oral contraceptives suggests factors other than gonadal hormones were responsible for these changes. Significant fluctuations were also noted across the cycle phases of the normally cycling women for all the hormones examined, as well as for body temperature, nasal airflow, and the MDZ Water Retention and Pain Scales. In the oral contraceptive group, very small but statistically significant changes were observed across the cycle in body temperature and in circulating levels of luteinizing hormone and estrone. Interrelations between a number of the variables were noted both within and across the test periods in all three subject groups. The results are discussed in relation to fluctuations reported in a number of sensory systems during the menstrual cycle.
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PMID:Endocrine, cardiovascular, and psychological correlated of olfactory sensitivity changes during the human menstrual cycle. 678 90

The self-report Symptom Checklist-90 (SCL-90) was used to screen 105 consecutive first-visit patients in an outpatient neurology clinic. Neurologists diagnosed a primary psychiatric disorder in 35 patients (33%) and a secondary psychiatric disorder in 5. The SCL-90 uncovered previously unidentified emotional distress in 14 patients, for an overall incidence of psychiatric symptoms of 51%. Pain was the most common chief complaint (N = 49), and pain patients accounted for 86% of the primary psychiatric diagnoses. Tricyclic antidepressants were the most often prescribed medications; 81% of these prescriptions were given to pain patients, usually in low doses. Depression was the most common diagnosis (N = 15). Despite the high incidence of psychiatric symptoms, only 3 patients received a psychiatric referral. Neurologists and consulting psychiatrists should maintain a high index of suspicion for psychiatric symptoms when examining patients complaining of pain and, after assessing the presence and severity of depression, prescribe tricyclics judiciously.
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PMID:Psychiatric symptomatology in an outpatient neurology clinic. 685 58

This study investigated the effects of three types of laboratory stressors (stressful imagery, mental arithmetic, pain) on temporal artery, skeletal muscle, general autonomic [digital blood volume pulse (DBVP), spontaneous resistance responses (SRR's)] and self-report measures of distress in chronic migraine, mixed, muscle contraction and non-headache controls. All subjects were female, free of medication at time of testing and equated for age. Headache subjects reported a 19 year history of headache. Results revealed a pattern of digital BVP (constriction), SSR's (increase) and frontal EMG (increase) indicative of a general autonomic-skeletal muscle arousal response to all three stressors in all groups, while the temporal artery response to the pain stimulus was vasodilation. Distress ratings were elevated during the stress periods for all four group. Pain threshold and tolerance and the tendency to utilize cognitive coping strategies during exposure to pain did not differ across the four groups. The results do not support the general autonomic dysfunction theory of migraine or the specificity hypothesis implicating an overreactive temporal artery or skeletal muscle response to stress in migraine and muscle contraction headache, respectively. Despite epidemiological research supporting the stress-headache relationship, the present results indicate that the psychophysiological mechanism underlying this relationship does not appear to involve abnormal tonic levels or phasic response to stress. It is argued that the temporal artery dilation response to pain questions the role of stress in triggering the two stage vasoconstriction-dilation mechanism of migraine and suggests the need to evaluate a four stage model as a potential psychophysiological mechanism underlying the stress-headache relationship.
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PMID:Stress and chronic headache: a psychophysiological analysis of mechanisms. 707 48

Recent studies have demonstrated that patients receiving cancer chemotherapy are more likely to have a successful treatment outcome if they receive optimal doses of drug continually. The current study was designed as a first step toward discovering factors that are associated with emotional distress during treatment and subsequent decisions by patients to delay, reduce, or terminate treatment. Interviews were conducted with 61 patients receiving chemotherapy for malignant lymphoma. Patients reported on side effects of treatment and their efforts to control them, their knowledge and beliefs about their illness, their strategies for monitoring the effectiveness of treatment, and the extent to which they had been prepared for the experiences of chemotherapy. Ratings of emotional distress were obtained on an 11-point self-report scale, and information about treatment schedules was obtained from medical records. The number of side effects experienced, but not the duration or severity, was positively correlated with distress. Vague, diffuse side effects such as tiredness and pain were more likely to be associated with distress than were acute, specific side effects such as nausea and vomiting. Patients who reported either unsuccessful attempts to cope with side effects or no attempts at all had greater distress than those who were coping successfully. Patients who developed conditioned nausea during treatment reported higher distress than those who did not.
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PMID:Factors contributing to emotional distress during cancer chemotherapy. 709 22

A predominantly non-student group of sixty-five women volunteers, screened for medication use, prospectively completed the Moos Menstrual Distress Questionnaire (MDQ) and the Temporal Disorganization Scale (TDS) weekly for one month along with a daily calendar of menstrual status. Data analysis revealed that TDS, concentration disturbances, negative affect, pain and water retention were rated as higher premenstrually and menstrually. Women dichotomized into groups based on high and low premenstrual TDS scores demonstrated different symptom patterns across the menstrual cycle. For the high premenstrual TDS group, concentration, behavioral change, negative affect and pain were all rated highest premenstrually; for the low premenstrual TDS and group the TDS score was rated highest menstrually. The relevance of these findings to literature reports of associations between psychopathology and menstrual cycle phase are discussed.
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PMID:Cognitive changes during the menstrual cycle. 720 87

Premenstrual syndrome (PMS) is a commonly encountered complaint among women. This study compared the PMS Diary (PMSD), which measures core menstrual symptoms (negative affect, water retention, and pain symptoms), with two commonly used self-rating forms, the Menstrual Distress Questionnaire (MDQ) and the Daily Rating Form (DRF). Thirty-seven premenopausal women with documented PMS completed the forms. A multitrait-multimethod analysis was performed to determine overall agreement and reliability. The three instruments and their component scale scores had strong internal consistency. Correlations between overall scores and between scales measuring similar constructs were strong. Correlations were 0.77 between PMSD and MDQ; 0.67 between PMSD and DRF; and 0.81 between MDQ and DRF. The PMSD performs as effectively as more extensive questionnaires in measuring symptoms in women with PMS. The PMS Diary is a concise yet reliable and valid instrument that can be easily administered in ambulatory care and longitudinal research.
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PMID:Comparative analysis of three PMS assessment instruments--the identification of premenstrual syndrome with core symptoms. 749 97

A randomly selected sample of 158 South Australian general practitioners (GPs) were sent a questionnaire which assessed opinions and management practices in the palliative care of terminally ill patients. A total of 117 responses (74%) were received. Most GPs were at least moderately satisfied with the care they were able to give their terminally ill patients, although a substantial number reported difficulties in pain and other symptom control, dealing with relatives' emotional distress and attending to patients' psychosocial needs. There was considerable support for continuing education in these aspects of palliative care. More than half were at least somewhat concerned by opioid side effects and impairment of cognitive function, although opioid dependence was not a concern. Considerable dissatisfaction was expressed with public hospital care for the terminally ill and most felt excluded from decision-making once their patients were admitted. The findings suggest that continuing education is required for GPs and that palliative care should become an integral part of undergraduate education. There is also a need to enhance communication and co-ordination between hospital and community-based services for the terminally ill.
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PMID:General practitioners and palliative care. 750 71

The primary objectives of this study were to determine the nature and extent of physical problems and psychological distress experienced by women with ovarian cancer and to identify medical and sociodemographic factors that were predictive of distress. Quality of life was assessed at 3-month intervals, for a maximum of 12 months in 151 ovarian cancer patients, most with advanced-stage disease (86%). Patients' pain, other physical symptoms, level of physical functioning, psychological state, and social functioning were evaluated using the following measures: a detailed pain questionnaire, Memorial Pain Assessment Card, Memorial Symptom Assessment Scale, Mental Health Inventory (MHI), Functional Living Index--Cancer (FLIC), and the Karnofsky Performance Status. Upon entry, 33% of patients reported significant psychological distress, as indicated by MHI Psychological Distress scores (MHI-PD) equal or greater to 1.5 standard deviations above the mean of a nationwide community sample. Impaired physical functioning (FLIC subscale) was the most important predictor of heightened psychological distress (MHI-PD) at baseline (1.5 SD or greater above the norm) (P = 0.0004) in a stepwise logistic regression involving medical/physical and sociodemographic variables as predictors. Further, significant differences were found in all quality of life scales between patients with Karnofsky Performance Status scores of < or = 80, and those with ratings of 90 or greater (P = 0.036 to P < 0.0001). These data suggest the need for an improved and more frequent assessment of ovarian cancer patients' psychological status, particularly as physical functioning declines, to improve early detection and referral to treatment of those suffering from psychiatric sequelae of cancer.
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PMID:Quality of life of women with ovarian cancer. 759 Apr 79

Debilitating gas pain is a common sequel for patients who have undergone abdominal surgery. Resulting from impaired motility induced by the mechanical and psychological stresses of surgery, as well as the effects of anaesthetic and analgesic agents, accumulated gas in the bowel often leads to longer and more unpleasant hospital stays. In this article, the authors describe ongoing research aimed at mediating gas effects in women post-hysterectomy. Using rocking as a moderator of the surgical stress response, the study hypothesizes a more rapid resumption of GI motility with decreased gaseous distention and associated pain, and less emotional distress for patients who follow a regimen of rocking in addition to ambulation. A sample of 34 patients is being studied, and data are being collected during a preadmission process and 5 postoperative days.
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PMID:Investigation of rocking as a postoperative intervention to promote gastrointestinal motility. 759 37


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