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Der Deutsche Schmerzfragebogen - Implementierte Psychometrie

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... It also includes a general Pain Intensity scale, where participants rated their waking-life pain intensity on an 11-point Likert scale from 0 (no pain) to 10 (unbearable). Based on a sample of N = 70 chronic pain patients, the affective scale showed a good internal consistency (Cronbach's a = 0.83) as well as a satisfying test-retest reliability (r = 0.79; Korb & Pfingsten, 2003). ...
... Patients rate how four adjectives describing the affective component fit their pain sensation on a 4-point scale (0-3), resulting in a sum of 0-12 (0 = no affective component, 12 = high affective component). [32] Marburg Questionnaire (FW7) Measures subjective well-being. Patients rate their affirmation of seven statements concerning well-being on a 6-point scale (0-5), resulting in a sum of 0-35 (0 = no subjective well-being, 35 = highest subjective well-being). ...
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The current Covid-19 pandemic has already had a definite impact on the daily life of many people worldwide. It has been proposed that people with preexisting medical conditions will be harder hit by the pandemic and the subsequent measures to contain the spread of the disease. In this questionnaire-based, observational study, we aimed to assess the impact of the pandemic on patients with a chronic pain disorder, who are treated at a tertiary multidisciplinary pain center.Participants rated the impact of the pandemic on their chronic pain disorder using a self-designed questionnaire. Also, participants filled out the regular follow-up questionnaire to assess a chronic pain disorder measuring among other parameters pain intensity, symptoms of depression, anxiety, stress, and pain-related quality of life.Of 136 eligible patients who presented to our pain center between May 5th and July 17th, 112 agreed to participate in the study (82.4%). Eighty two participants (73.2%) reported a deterioration of the pain disorder using the self-designed questionnaire. The more robust parameters of the regular follow-up questionnaire showed no relevant changes compared to data collected before the pandemic. We were not able to detect any demographic and medical parameters that were clinically relevantly associated with a higher impact of the pandemic.We conclude that a chronic pain disorder is a relatively stable disease that does not change significantly due to external factors, like the Covid-19 pandemic, even if the subjective impact is perceived to be high.
... Higher values are conspicuous. The internal consistency was confirmed with Cronbach's alpha between 0.79 and 0.83 [50]. ...
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Article
Objective: The purpose of this study was to find applicable clusters for the development of different treatment pathways in an inpatient multimodal pain-therapy setting based on the multifaceted nature of CLBP. Methods: Based on data of questionnaires (Hospital Anxiety and Depression Scale (HADS), Marburg Questionnaire on Habitual Health Findings (MFHW), quality of life assessment using the Short-Form 12 (SF 12)), a retrospective two-step cluster analysis involving a sample of chronic low back pain (CLBP) patients (N=320) was calculated. Subsequently, the clusters were precisely described and compared on the basis of further data collected during the patients' standard care: pain characteristics, socio-demographic data and the general state of health, psychological variables, therapy intensity, and Diagnosis Related Groups (DRG) data. Results: We found a three-cluster solution: little psychological interference but marginal physical and mental quality of life (Cluster 1); poor well-being, low physical quality of life, and marginal mental quality of life (Cluster 2); and heavy mental strain and marginal physical quality of life (Cluster 3). Conclusions: Similar to previous studies, our results suggest that patients suffering from CLBP differ with regard to the magnitude of mental burden and the presence of physical impairment. These differences ascertain the need for precise targeting of treatment for CLBP. Inpatient pain centers therefore should offer different multimodal therapy pathways and integrate a meaningful triage, taking into account the multifaceted nature of CLBP based on sophisticated knowledge about forms, differences, and relationships among the biopsychosocial components of CLBP. Copyright © 2019 Langenmaier et al.
... Pain intensity was measured using a 0-100 mm visual analog scale from the German Pain Questionnaire 21,22 with 0 mm indicating 'no neck pain at all' and 100 mm indicating 'worst neck pain imaginable'. Psychological distress was measured by the Hospital Anxiety and Depression Scale (HADS) 23,24 with the two dimensions anxiety and depression, with higher values indicating higher psychological distress. ...
Article
Study design: Secondary analysis of a randomized controlled trial OBJECTIVE.: This secondary analysis aims to examine associations of improvement of chronic neck pain with patients' and intervention-related characteristics. Summary of background data: Previous research has found that Tai Chi and neck exercises significantly improved chronic non-specific neck pain; however the factors for treatment success remain unclear. Methods: Subjects with chronic non-specific neck pain were randomly assigned to 12 weeks of group Tai Chi or conventional neck exercises, and they attended 12 weekly sessions of 60-90 minutes. The interventions included exercises to improve body awareness, i.e. interoceptive and postural awareness. A linear forward stepwise regression analysis was conducted to examine associations with improvements in neck pain intensity. Potential predictor variables included baseline pain, age, gender, the type of intervention, attendance rate and home practice duration, and changes in psychological well-being, perceived stress, postural and interoceptive awareness during the study. Results: Overall 75 patients were randomized into Tai Chi or conventional exercises, with the majority being female (78.7%). Participants reported an average pain intensity of 50.7 ± 20.4 mm VAS at baseline, and the average reduction of pain intensity in both groups was 21.4 ± 21.3 mm VAS. Regression analysis revealed that reductions in pain intensity from baseline to 12 weeks were predicted by higher pain intensity at baseline (r = 0.226, p < 0.001), a decrease in anxiety (r = 0.102, p = 0.001), and an increase in postural awareness (r = 0.078, p = 0.0033), explaining a total of 40.6% of variance. Conclusions: Neck pain improvement was significantly associated with changes in postural awareness in subject with chronic non-specific neck pain independent of treatment characteristics. Training of postural awareness might be an important mechanism of action of different exercise-based interventions for chronic neck pain. Level of evidence: 1.
... Current pain intensity was measured using a 0 to 100 mm VAS from the German Pain Questionnaire, 15 with 0 mm indicating "no knee pain at all" and 100 mm indicating "worst knee pain imaginable." ...
Article
Objectives:Osteoarthritis (OA) of the knee is one of the most common chronic diseases among older adults. This study aimed to test the effects of cabbage leaf wraps (CLWs) in the treatment of symptomatic OA.Methods:Patients with OA of the knee at stages II to III (Kellgren-Lawrence) were randomly assigned to 4 weeks of treatment with CLWs (daily for at least 2h), topical pain gel (TPG) (10 mg diclofenac/g, at least once daily), or usual care (UC). The primary outcome measure was pain intensity (VAS) after 4 weeks. Secondary outcomes included functional disability Western Ontario and McMaster Universities Arthritis Index (WOMAC), quality of life (SF-36), self-efficacy (Arthritis Self-Efficacy Scale-D), physical function (30 s Chair Stand Test), pressure pain sensitivity (PPT), satisfaction, and safety after 4 and 12 weeks.Results:In total, 81 patients were included in this study (42 women, 65.910.3 y). After 4 weeks patients in the CLW group reported significantly less pain compared with those in the UC group (difference, -12.1; 95% [confidence interval] CI, -23.1, -1.0; P=0.033) but not when compared with the TPG group (difference, -8.6; 95% CI, -21.5, 4.4; P=0.190). Significant effects were also found in WOMAC, SF-36, 30-second Chair Stand Test, and PPT scores in the CLW group compared with the UC group. Compared with TPG, effects from CLW were found for WOMAC after 4 weeks and for quality of life after 12 weeks. Patients were satisfied with both active interventions, and except for 2 adverse events in both groups the applications were well tolerated.Conclusions:CLWs are more effective for knee OA than UC, but not compared with diclofenac gel. Therefore, they might be recommended for patients with OA of the knee. Further research is warranted.
... In vorhergehenden Untersuchungen konnten bereits sieben relevante Dimensionen zur Erfassung der Nutzerzufriedenheit identifiziert werden: Zufriedenheit, Sicherheitsgefühl, Körperschemaintegration, Unterstützung, Schaft, Mobilität und Außenwirkung [16]. Es sollen jedoch nicht nur Nutzererleben, Tragekomfort und Zufriedenheit erfasst werden, sondern darüber hinausgehend auch Schmerzerleben und physische Funktionen [17]. Zu diesem Zweck können psychophysiologische Messmethoden wie Herzratenvariabilität oder elektrodermale Aktivität verwendet werden [18]. ...
Article
This article introduces a research project which deals with the objectification of the socket adjustment process for lower limb prostheses. The relevance of socket fitting, the current procedure, and the latest research approaches are discussed. Based on this, the proposed research concept is presented. It relies on experimental measurement data collection, modelling the dynamics of residual limb-socket interaction during gait and the consideration of user experiences and the prosthetists’ expert knowledge in the fitting process. These three approaches and their integration in a design process are described and explained in detail. In addition, first results of a discussion with experts of an interdisciplinary team are presented: inclusion criteria for test subjects as well as critical geometric areas for fitting narrow mediolateral prosthetic sockets.
... In vorhergehenden Untersuchungen konnten bereits sieben relevante Dimensionen zur Erfassung der Nutzerzufriedenheit identifiziert werden: Zufriedenheit, Sicherheitsgefühl, Körperschemaintegration, Unterstützung, Schaft, Mobilität und Außenwirkung [16]. Es sollen jedoch nicht nur Nutzererleben, Tragekomfort und Zufriedenheit erfasst werden, sondern darüber hinausgehend auch Schmerzerleben und physische Funktionen [17]. Zu diesem Zweck können psychophysiologische Messmethoden wie Herzratenvariabilität oder elektrodermale Aktivität verwendet werden [18]. ...
Full-text available
Article
This article introduces a research project which deals with the objectification of the socket adjustment process for lower limb prostheses. The relevance of socket fitting, the current procedure, and the latest research approaches are discussed. Based on this, the proposed research concept is presented. It relies on experimental measurement data collection, modelling the dynamics of residual limb-socket interaction during gait and the consideration of user experiences and the prosthetists’ expert knowledge in the fitting process. These three approaches and their integration in a design process are described and explained in detail. In addition, first results of a discussion with experts of an interdisciplinary team are presented: inclusion criteria for test subjects as well as critical geometric areas for fitting narrow mediolateral prosthetic sockets.
... Current pain intensity was measured using a 0-to 100-mm VAS from the German Pain Questionnaire 35,44 with 0 mm indicating 'no neck pain at all' and 100 mm indicating 'worst neck pain imaginable.' ...
Article
Unlabelled: This study aimed to test the efficacy of Tai Chi for treating chronic neck pain. Subjects with chronic nonspecific neck pain were randomly assigned to 12 weeks of group Tai Chi or conventional neck exercises with weekly sessions of 75 to 90 minutes, or a wait-list control. The primary outcome measure was pain intensity (visual analogue scale). Secondary outcomes included pain on movement, functional disability, quality of life, well-being and perceived stress, postural and interoceptive awareness, satisfaction, and safety. Altogether, 114 participants were included (91 women, 49.4 ± 11.7 years of age). After 12 weeks Tai Chi participants reported significantly less pain compared with the wait list group (average difference in mm on the visual analogue scale: -10.5; 95% confidence interval, -20.3 to -.9; P = .033). Group differences were also found for pain on movement, functional disability, and quality of life compared with the wait list group. No differences were found for Tai Chi compared with neck exercises. Patients' satisfaction with both exercise interventions was high, and only minor side effects were observed. Tai Chi was more effective than no treatment in improving pain in subjects with chronic nonspecific neck pain. Because Tai Chi is probably as effective as neck exercises it may be considered a suitable alternative to conventional exercises for those with a preference toward Tai Chi. Perspective: This article presents results of a randomized controlled trial comparing Tai Chi, conventional neck exercises, and no treatment for chronic nonspecific neck pain. Results indicate that Tai Chi exercises and conventional neck exercises are equally effective in improving pain and quality of life therefore representing beneficial interventions for neck pain.
... Current pain intensity was measured using a 0-100mm visual analog scale from the German Pain Questionnaire [15] with 0mm indicating 'no knee pain at all' and 100mm indicating 'worst knee pain imaginable'. ...
Article
Zur Behandlung der Kniearthrose steht den Betroffenen eine Vielzahl von Hausmitteln zur Verfügung, u. a. die Kohlblattauflagen. Diese haben sich in der Praxis zur Reduktion von Schmerzen, Schwellungen und Bewegungseinschränkungen bewährt, die vorliegende Studie hat erstmals deren Wirksamkeit bei Beschwerden aufgrund von Knie- arthrose wissenschaftlich untersucht. Summary An examination of the efficacy of cabbage leaf wraps in treating symptomatic osteoarthritis of the knee A variety of home remedies, among others cabbage leaf wraps, are available for the patient for the treatment of knee osteoarthritis. The wraps have proved effective in practice in the reduction of swelling, pain and movement restrictions. For the first time, the present scientific study offers proof of the effectiveness of cabbage wraps in treating disorders related to knee osteoarthritis.
... Patients' affective perception of pain was measured using the Pain Description List (SBL), a 12-item short form of the Pain Perception Scale (SES) [23]. The SBL is part of the validated German Pain Questionnaire (DSF) [24,25]. It includes four items describing affective dimensions of pain. ...
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Article
Chronic neck pain is a major public health problem with very few evidence-based complementary treatment options. This study aimed to test the efficacy of 12 weeks of a partner-delivered home-based cupping massage, compared to the same period of progressive muscle relaxation in patients with chronic non-specific neck pain. Patients were randomly assigned to self-directed cupping massage or progressive muscle relaxation. They were trained and asked to undertake the assigned treatment twice weekly for 12 weeks. Primary outcome measure was the current neck pain intensity (0-100 mm visual analog scale; VAS) after 12 weeks. Secondary outcome measures included pain on motion, affective pain perception, functional disability, psychological distress, wellbeing, health-related quality of life, pressure pain thresholds and adverse events. Sixty one patients (54.1±12.7 years; 73.8%female) were randomized to cupping massage (n = 30) or progressive muscle relaxation (n = 31). After treatment, both groups showed significantly less pain compared to baseline however without significant group differences. Significant effects in favor of cupping massage were only found for wellbeing and pressure pain thresholds. In conclusion, cupping massage is no more effective than progressive muscle relaxation in reducing chronic non-specific neck pain. Both therapies can be easily used at home and can reduce pain to a minimal clinically relevant extent. Cupping massage may however be better than PMR in improving well-being and decreasing pressure pain sensitivity but more studies with larger samples and longer follow-up periods are needed to confirm these results. ClinicalTrials.gov NCT01500330.
Article
Background Chronic pain is a worldwide problem of healthcare along with social and economic factors. The Center for Pain Medicine (CPM) Nottwil offers individualized, interdisciplinary, multimodal pain rehabilitation based on the biopsychosocial approach. The aim of this study was to obtain a real-life analysis of chronic pain patients who were treated at the CPM Nottwil, to understand how they were treated and to analyze the long-term effects of the treatment.Methods In a retrospective cohort study data of all patients who underwent a first medical examination at the CPM Nottwil in 2011 were included in the study. The effectiveness of the treatment was analyzed in a 3-year follow-up measurement. The main outcome was the general well-being of the patient.ResultsIn 2011, 628 chronic pain patients underwent a first medical examination at the CPM Nottwil. They showed low values in the dimension of general well-being and a high impairment due to severely limiting pain intensity. Although the power analysis suggested a sample size of 170 patients for the follow-up measurement, only 46 participants (responders) were included in the final analysis. Baseline characteristics between responders and non-responders of the follow-up-group showed statistically significant differences for health-related quality of life (SF-12) and the anxiety and depression scale (HADS), but not for other sample characteristics. Improvement from pretreatment to follow-up emerged in the dimension of well-being, physical well-being and pain intensity. At follow-up 30% reported being pain-free.Conclusion Individualized, interdisciplinary, multimodal and mostly outpatient pain programs are an effective treatment for patients suffering from chronic pain in the long term. For the first time this effect has been proven in a clinically representative cohort. Limitations of this study are low response rates in the follow-up group and differences in baseline characteristics (anxiety, depression and quality of life) between responders and non-responders.
Chapter
Die Anamnese ist mit der sich anschließenden körperlichen Untersuchung wesentlicher Bestandteil der Diagnostik und somit Grundlage für spätere therapeutische Maßnahmen. Als Ergänzung zum ausführlichen Anamnesegespräch sind standardisierte Verfahren zur Erhebung der Krankengeschichte in Form von Fragebögen sinnvoll. Für die erfolgreiche Behandlung von langandauernden Schmerzen müssen die Besonderheiten, die sich aus dem chronischen Verlauf ergeben, ebenfalls erfasst werden.
Article
Background The subjective state of health with respect to pain and psyche was surveyed utilizing validated pain questionnaires in patients undergoing special pain therapy and represents the basis for targeted treatment measures. Objective The purpose of this study was to investigate the possible distortion of answers due to social desirability of responses in chronic pain patients. Material and methods During two survey periods assessing patient satisfaction using both anonymized and personalized questionnaires, the effects arising from socially desirable response patterns were analyzed. The sample consisted of chronic pain patients being treated in an inpatient therapy setting. Results In both periods of observation no significant impact on the response behavior of chronic pain patients was found in personalized or anonymized questionnaires. Conclusion The results of the study suggest that the responses of chronic pain patients with respect to their subjective state of health are not influenced by social desirability. Thus, scoring systems such as the German pain questionnaire will not be influenced by social desirability in chronic pain patients and can therefore be used as a part of diagnostics and therapy planning.
Chapter
In diesem Beitrag werden wir auf Voraussetzungen und Besonderheiten eingehen, die bei der psychologischen Anamnese von Patienten mit chronischen Schmerzen wichtig sind. Ausgehend von unseren eigenen Erfahrungen schlagen wir – nach einer kurzen theoretischen Einführung – Strukturierungshilfen vor, geben Hinweise auf typische Hürden und Probleme und gehen auf mögliche weitere Konsequenzen für die Patienten ein. Unsere Absicht ist es, vor allem praktische Hilfen und Hinweise sowie eine praxisnahe Anleitung mit beispielhaften Gesprächssequenzen und Vorschlägen zur Problemlösung zu geben.
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Article
This study aimed to test the efficacy of cupping therapy to improve symptoms and quality of life in patients diagnosed with the fibromyalgia syndrome. Participants were randomly assigned to cupping therapy, sham or usual care. Cupping was administered five times at twice weekly intervals on the upper and lower back. The primary outcome measure was pain intensity at day 18. Secondary outcomes included functional disability, quality of life, fatigue and sleep quality as well as pressure pain sensitivity, satisfaction and safety at day 18 and 6 months. Altogether 141 patients were included in this study (139 females, 55.8 ± 9.1 years). After 18 days patients reported significant less pain after cupping compared to usual care (difference -12.4; 95% CI: -18.9; -5.9, p < 0.001) but not compared to sham (difference -3.0; 95% CI: -9.9, 3.9, p = 0.396). Further effects were found for quality of life compared to usual care. Patients were mildly satisfied with cupping and sham cupping; and only minor side effects were observed. Despite cupping therapy being more effective than usual care to improve pain intensity and quality of life, effects of cupping therapy were small and comparable to those of a sham treatment, and as such cupping cannot be recommended for fibromyalgia at the current time.
Article
In the widely used German pain questionnaire, qualitative pain characteristics are assessed by the Schmerzbeschreibungsliste (SBL). In clinical practice these adjectives insufficiently cover the spectrum of orofacial pain perceptions (OFP) and have not been proven by data. The aim of this study was the analysis of a questionnaire focussing on OFP (ZZM-FB) in which nine additional pain descriptors were amended to the SBL (SBL-OF). The objectives of this work were to (1) compare selection frequencies between the items of the SBL and the SBL-OF and (2) test the null hypothesis that the SBL and SBL-OF item selection is not influenced by gender, age, pain features (intensity, duration, time pattern, distribution), hospital anxiety and depression scale (HADS) and diagnosis. A total of 224 patients consecutively referred to the interdisciplinary OFP unit between 2010 and 2012 completed a ZZM-FB. The corresponding diagnosis was obtained from the clinical reports. In all, 209 OFP-Q were anonymized and data retrospectively analysed at a significance level of p ≤ 0.01. The descending rank order of the 12 most frequently selected items was as follow: pressing (SBL), dull (SBL), pulling (SBL), stinging (SBL), dreadful (SBL), miserable (SBL), exhausting (SBL-OF), grueling (SBL-OF), agonizing (SBL-OF), atrocious (SBL), horrible (SBL), pulsating (SBL). The null hypothesis was rejected for all parameters except for age. The selection frequency was significantly influenced by gender, pain intensity, duration and distribution, time pattern, HADS values and diagnosis. In this cohort, some ADD descriptors were selected more frequently than some SBL items, indicating that the SBL does not adequately capture the characteristics of OFP. These results will be considered in the construction of a revised ZZM-FB, which is currently in development.
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Conference Paper
Background / Purpose: The Algesiologikum group is engaged in treatment of patients suffering from chronic pain in three urban (Munich) and one rural (Vilsbiburg) in-patient pain medicine centres. The aim of the study was to evaluate the relation between pain characteristics, psychological variables and the dosage of multimodal pain therapy. Main conclusion: We found weak significant correlations between dosage of multimodal pain therapy with chronic pain grade and anxiety. Surprisingly no correlations were found between depression, general well-being and quality of life with the number of multimodal therapy units.
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Current studies suggest dysfunctional emotional processing as a key factor in the aetiology of temporomandibular disorder (TMD). Investigating facial emotion recognition (FER) may offer an elegant and reliable way to study emotional processing in patients with TMD. Twenty patients with TMD and the same number of age-, sex- and education-matched controls were measured with the Facially Expressed Emotion Labelling (FEEL) test, the 26-item Toronto Alexithymia Scale (TAS-26), the Screening for Somatoform Symptoms (SOMS-2a), the German Pain Questionnaire and the 21-item Hamilton Depression Rating Scale (HAMD). The patients had significantly lower Total FEEL Scores (P = 0·021) as compared to the controls, indicating a lower accuracy of FER. Furthermore, we were able to demonstrate significant group differences with respect to the following issues: patients were more alexithymic (P = 0·006), stated more somatoform symptoms (P < 0·004) and had higher depressive scores in the HAMD (P < 0·003). The factors alexithymia and somatisation could explain 31% (adjusted 27%) of the variance of the FEEL Scores in the sample. The estimation of the standardised regression coefficients suggests an equivalent influence of TAS-26 and SOMS-2a on the FEEL Scores, whereas 'group' (patients versus healthy controls) and depressive symptoms did not contribute significantly to the model. Our findings highlight FER deficits in patients with TMD, which are partially explained by concomitant alexithymia and somatisation. As suggested previously, impaired FER in patients with TMD may further point to probable aetiological proximities between TMD and somatoform disorders.
Article
Sleep deprivation was found to exert complex effects on affective dimensions and modalities of pain perception both in healthy volunteers and patients with major depression. Considering multifaceted links between mood and pain regulation in patients with chronic somatoform pain, it is intriguing to study sleep deprivation effects for the first time in this group of patients. Twenty patients with a somatoform pain disorder according to ICD-10 diagnostic criteria were sleep-deprived for one night, followed by one recovery night. Clinical pain complaints (visual analog scale), detection- and pain thresholds (temperature and pressure) as well as mood states (Profile of Mood States) were assessed on the day prior to the experiment, on the day after sleep deprivation and on the day after recovery sleep. We found a discrepancy between significantly increased clinical pain complaints and unaltered experimental pain perception after sleep deprivation. Only the clinical pain complaints, but not the experimental pain thresholds were correlated with tiredness-associated symptoms. Total mood disturbances decreased and feelings of depression and anger improved significantly after sleep deprivation. However, these changes were not correlated with a change in clinical pain perception. We conclude that sleep deprivation may generally change the reagibility of the limbic system, but mood processing and pain processing may be affected in an opposite way reflecting neurobiological differences between emotional regulation and interoceptive pain processing.
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