The role of psycho-social factors in IUD continuation.
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Biomedical subjects
Publications and source records attributed to A E Reading.
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The McGill pain questionnaire (MPQ) was administered to 166 women attending Gynaecology Clinics complaining of dysmenorrhoea. Responses were subjected to factor analysis with 4 dimensions emerging. These reflected sensory qualities of the pain experience and factors related to the reaction component of the pain. These results are considered in relation to factorial analysis of the MPQ among back patients and in terms of treatment implications.
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This paper considers the problem of measuring the subjective report of pain. In view of the limitations of existing approaches an alternative method of pain assessment is proposed. This approach derives from a multidimensional concept of pain. The test is in the form of pair comparisons and is designed to measure different pain dimensions. Sufficient consensus was found over the meaning and relevance of words describing intrauterine device related pain and primary dysmenorrhoea to allow a standard test to be developed. The reliability of the test was found to be high and its clinical advantages promising. It was not possible to provide an adequate evaluation of the test's validity. In view of these findings a longer-term treatment evaluation study is currently being undertaken in order to establish this.
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A pain questionnaire designed to measure sensory, affective, evaluative and temporal components of pain was administered to 119 patients with primary dysmenorrhoea and 75 patients with intrauterine device (IUD) related pain. In addition "self-report" information was obtained on the behavioural effects of pain, global ratings and biographical details of these patients. It was found that dysmenorrhoea and IUD related pain were generally similar in nature. This led to the conclusion that IUD insertion does not in general lead to an exacerbation of presenting dysmenorrhoea, nor does it radically alter the type of sensations experienced by the patient. While no differences between patient groups emerged, the implications of the different pain components did vary. Thus, pain intensity scores were reflected in a larger sensory component with IUD users, whereas with dysmenorrhoea the affective component predominated. The results show sufficient consensus in the two patient groups of word adjectives used to describe their pain, to allow the development and evaluation of a rapid card sort system for pain assessment.
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Chronic pelvic pain is a common presenting complaint in gynecology clinics. In a proportion of cases no pathology or sufficient pathology can be found to account for the level of complaint. This paper reviews the evidence on the psychological characteristics of patients presenting with chronic pelvic pain without obvious pathology. Methodological considerations are identified in order to guide future research. There is a need for prospective studies, in which women with pelvic pain of whatever etiology are evaluated, in order to provide contextual data and to identify predictors of treatment response.