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Biomedical subjects

A E Reading

Publications and source records attributed to A E Reading.

At least 37 records · Page 2Linked to original sources
PubMed1983

Pain measurement and experience.

Issues and developments in clinical pain assessment will be considered. The focus will be on measuring pain, rather than degree of relief. Three main response channels may be distinguished: subjective, behavioral and physiological, although the latter will not be elaborated upon here. The measurement of subjective report of pain, although an anathema to behaviorists, continues to be one of the most widely used measures. Recent developments in assessing verbal report, of the form of questionnaires and ratings derived from psychophysical scaling methods, will be reviewed. Although behavioral indices at first sight lend themselves to well-established methods of measurement, issues in establishing rather than assuming the reliability and validity of such measures will be considered. Parallel monitoring across response channels, as well as attending to questions concerning the psychometric adequacy of measures employed, will both further our understanding of pain mechanisms and provide sound indications as to treatment efficacy.

Behavior↗
PubMed1983

A controlled trial of naproxen sodium for relief of pain associated with Vabra suction curettage.

In a double-blind study naproxen sodium (550 mg), or placebo was administered 1 h before Vabra curettage and pain associated with the procedure was assessed immediately after operation and 30, 60 and 120 min later by visual analogue and verbal rating scales, and the McGill pain questionnaire. The pre-curettage anxiety of the patients was assessed by the Spielberger state anxiety inventory. Of the 58 patients, 51 (87.9%) reported pain during the procedure; there was no relation between the level of pain experienced and the pre-curettage anxiety score. Compared with the placebo group, the pain experienced by the naproxen group was significantly less as measured by the McGill pain questionnaire immediately after curettage, and by visual analogue scales 30 and 60 min after the procedure. The verbal rating scales showed that naproxen significantly reduced backache 30 min after curettage, and cramp immediately after the procedure and 30 and 60 min later but did not reduce the severity of the pain associated with the procedure.

Anxiety↗
PubMed1983

Psychological issues resulting from the development of new male contraceptives.

I am grateful to Dr. Fielding for his comments on male sexuality, which our paper (Bulletin, October 1982) prompted. However, I fear his concerns to be as misplaced as his citation ('unpublished observations') will remain elusive. The study cited in the paper will be published in full elsewhere (Journal of Behavioral Assessment). No assumptions were made about the nature of the processes under investigation; we were merely interested in the reliability of different recording methods. Our parameters were defined by previous research carried out by the World Health Organization's Special Program of Research in Human Reproduction (1982), with the relationship of morning erections to bladder distension duly acknowledged. Dr. Fielding's remaining points are equally misleading. Although we may all speculate on the merits or demerits of retarding ejaculation, our preference would be to obtain data, particularly in view of the cross-cultural significance of such information. Similarly, that spermatozoa constitute less than 1% of the total volume of ejaculatory fluid is academic in the absence of precise methods of abolishing spermatogenesis without impairing sexuality or health status. The question as to the potential acceptability of hypothetical methods decreasing volume of ejaculate remain, especially when considering the important distinction between objective and subjective appraisals of change (Marshall, 1977).

Behavior↗
PubMed1982

How women view postepisiotomy pain.

Episiotomy is one of the most commonly performed operative procedures and yet little information is available on the subjective reactions in the puerperium to this procedure. The present study was designed to furnish information on the attitudes of patients, levels of pain, and of course recovery by studying a consecutive series of 101 Caucasian primiparea who received episiotomies at delivery. Women were interviewed within 24 hours of delivery and then, at three months after delivery, completed a questionnaire. The high level of pain experienced was noteworthy. Labour pain and episiotomy pain were uncorrelated, indicating the importance of distinguishing between them. Several women were experiencing problems at the three-month follow-up, with some attributing these to the episiotomy repair. The data are presented in the framework of providing women in the postpartum period with systematic information on the nature of postepisiotomy pain and subsequent recovery to facilitate their adjustment.

Activities of Daily Living↗
PubMed1982

The effects of psychological preparation on pain and recovery after minor gynaecological surgery: a preliminary report.

Investigated the effects of psychologically preparing patients for minor gynaecological surgery. A total of 59 women who were undergoing elective laparoscopy were assigned randomly to three experimental conditions: Preparation, in which an informative preoperative interview was conducted; placebo, in which a reassuring preoperative interview was held; and control, in which no contact was made prior to surgery. The women were assessed postoperatively in terms of pain, anxiety and attitudes and required to complete a follow-up questionnaire that followed a 3-week interval, which assessed subjective report of recovery rate. The results showed similar levels of pain report for all groups, although significantly fewer prepared patients requested postoperative analgesia. No differences in pain reports emerged at follow-up, although there was a tread for prepared patients to report a more rapid return to full health. The results are considered in the context of explanatory models that have been proposed to account for the effects of psychological preparation.

Adaptation, Psychological↗
PubMed1982

The effects of ultrasound examination on maternal anxiety levels.

A study has been conducted to assess the psychological effects of real-time ultrasound on the pregnant woman's attitudes and anxiety levels. A consecutive series of primiparae, fulfilling the selection criteria of obstetrically "low risk," was assigned at random to two conditions of ultrasound, namely, (a) high feedback (N = 67), where the woman saw the moving fetus in utero; and (b) low feedback (N = 62), where the monitor screen was not visible and no specific feedback was provided. A third group of women was assessed following a wait period in order to compare state anxiety levels among the three groups. Attitude assessments showed consistent preultrasound-post-ultrasound change, with more uniformly positive attitudes displayed by the high-feedback group. No between-group differences in state anxiety emerged as a result of ultrasound compared with a wait control period. No differences emerged with respect to anticipatory anxiety measures. The results are considered in the context of evidence on the importance of psychological state on the course and outcome of pregnancy. It is suggested that the low-risk characteristics of this sample may have precluded effects on anxiety and it is concluded that the therapeutic potential of ultrasound warrants further study.

Adult↗
PubMed1982

A survey of patient attitudes towards artificial insemination by donor.

The psychological characteristics of a consecutive series (n = 58) of women attending an AID clinic have been examined. Women were assessed prior to treatment on a number of attitudinal and acceptability measures, as well as required to complete personality and martial adjustment inventories. At the time of each insemination, over 6 successive cycles, state anxiety was assessed. Following an interval of 6 months women were reassessed on an acceptability measure. The results showed generally positive attitudes at the outset. No systematic trends in anxiety were identified, with no differences between women becoming pregnant and those continuing in treatment. At follow-up women acknowledged the strain involved in timing the insemination to coincide with ovulation, with both pregnant and nonpregnant women attributing outcome to their psychological and emotional state at the time. The implications of these results are considered in terms of the characteristics of women requesting AID and the ways in which clinics can attend to the psychological states of the patients.

Adult↗
PubMed1982

Health beliefs and health care behaviour in pregnancy.

Primiparae were randomly assigned to two conditions of routine ultrasound examination at their first antenatal clinic visit: (a) high feedback ultrasound where the monitor screen was visible and the patient was shown the foetal size, shape and movement (N = 67); (b) low feedback ultrasound where the screen was not seen and specific verbal feedback was denied (N = 62). Women were interviewed at 16 weeks gestation. Those receiving high feedback were more likely to report that they had acted on health advice given at the first antenatal visit to reduce their smoking and drinking.

Adolescent↗
PubMed1982

Strategic and methodological aspects of behavioural medicine.

There is currently an expanded interest amongst clinical psychologists in extending their clinical service to other medical specialties in addition to psychiatry. The present paper considers the strategic and methodological implications of this trend. It is suggested that the efficient use of limited resources demands an expanded role, which involves the evaluation of service-related problems in addition to traditional casework. A further departure from the traditional role involves the development and refinement of measures of psychological state in clinical research trials. Examples of the way in which involvement may be exhibited on a methodological level are offered by considering psychological aspects of medication. In order to establish the clinical utility of such collaboration, it is necessary to provide biomedical personnel with empirical documentation of the benefits of attending to the psychological aspects of their clinical practice.

Behavior Therapy↗
PubMed1982

The McGill Pain Questionnaire: a replication of its construction.

The McGill Pain Questionnaire is in widespread use as a means of understanding the pain patient and monitoring treatment response. The current study consists of a replication of the construction of the questionnaire through the use of maximally dissimilar methodology and statistical techniques. The study comprised two stages: (a) an attempt to replicate the grouping of words within the questionnaire; and (b) an investigation of the intensity relationships of words within each subgroup. A direct grouping technique was used for stage (a), whereby 90 subjects sorted the words into semantically similar groups. A similarity matrix was constructed in terms of the number of times each word was associated with each of the other 78 words and subjected to cluster analysis. Inspection of the 20-group solution revealed considerable similarity with the original questionnaire. The intensity relationships were examined by asking a further group of 20 subjects to rate words on analogue scales. The results suggest a unidimensional solution to be inappropriate for a proportion of the subgroups. While there was a close resemblance with the MPQ, there was evidence for reducing the number of subgroups, as a 16-group solution offered a sensible and statistically parsimonious amalgamation. The implications of this work for the use of questionnaire methods are discussed.

Female↗
PubMed1981

Psychological aspects of Vabra curettage in menopause clinics.

A study has examined the psychological reactions toward undergoing Vabra curettage in a menopause clinic. An unselected sample of women (n = 30) were assessed pre and post the procedure on a number of pain, stress and attitudinal measures. The results document the pain experienced with this procedure. A range of anxiety levels was evident, with in some cases pronounced anxiety identified. In spite of these negative experiences, attitudes were generally positive towards subsequent curettage and the majority of women were aware of the objectives of this procedure. The results suggest the possibility of attempting to reduce discomfort and anxiety levels. This could be accomplished by psychologically or pharmacologically preparing the patient. The present study offers a model whereby such interventions could be evaluated.

Anxiety↗
PubMed1980

An analysis of the intensity and quality of gynecological pain.

It is evident that the pain experience varies qualitatively as well as in intensity. A number of methods to assess both the intensity and quality of pain have been reported. This paper presents the results of a card sort method of pain assessment in the measurement of gynecological pain, which provides a score from 1 to 4 for 10 pain qualities. Factor analysis has identified 3 main clusters or pain dimensions: sensations, reaction and a tiring/duration dimension. Comparative data is presented on 5 main pain types using this method: dysmenorrhea, IUD related pain, IUD insertion pain, postoperative pain and post-partum pain. A total of 232 patients were assessed. The results permit comparisons between pain types for both intensity as well as quality. This distinction may have implications for pain management. Thus although dysmenorrhea and IUD related pain were similar in terms of sensations, dysmenorrhea was rated significantly higher in terms of the reaction component. Similarly, both IUD insertion pain and post-partum pain received high reaction scores. The implications of such a score profile are discussed. Thus, these scores may result from the unexpected nature of the pain sensations rather than their high intensity. In which case inclusion of psychological preparation may have been of benefit. Similarly with pelvic pain of unknown organic origin, substantial relief may be provided by focussing on the reaction component, where this is elevated, and removing the worry surrounding the sensations.

Adult↗