Physical Functioning: Mobility

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Working Paper No.3 Add.4 11
November 2005 STATISTICAL COMMISSION
and STATISTICAL OFFICE OF THE UN ECONOMIC
COMMISSION FOR EUROPEAN COMMUNITIES EUROPE
(EUROSTAT)   CONFERENCE OF EUROPEAN WORLD
HEALTH STATISTICIANS ORGANIZATION
(WHO) Joint UNECE/WHO/Eurostat Meeting on the
Measurement of Health Status (Budapest, Hungary,
14-16 November 2005)   Session 3 Invited paper
Pain and Discomfort
Jennifer MadansNational Center for Health
Statistics, U.S.A
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Pain

• Concept
• Pain is an unpleasant sensation that can range
  from mild, localized discomfort to agony. Pain
  has both physical and emotional components. The
  physical part of pain results from nerve
  stimulation. Pain may be contained to a discrete
  area, as in an injury, or it can be more diffuse,
  as in disorders like fibromyalgia. Pain is
  mediated by specific nerve fibers that carry the
  pain impulses to the brain where their conscious
  appreciation may be modified by many factors."
• Cannot be measured directly, but it is the
  subjective experience of pain that determines the
  consequences for the person and for society

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Pain (cont.)

• Components
• Intensity
• Pain vs. Discomfort (separate concepts or on a
  continuum)
• Location
• Frequency/Constancy
• Attribution
• Multiple causes not always known
• Impact
• Does severity need to be measured through impact

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Proposed items for measuringpain and discomfort

• PAIN Have you had any pain during the
  past(days/weeks/months) (all types of pain).
• Yes (if yes proceed to question FREQ_PAIN) ?
• No
• FREQ_PAIN Thinking about the past(days/weeks/mo
  nths) How often did you have pain?
• All the time (non-stop)
• Daily (with pauses)
• Several days per week, but not every day
• One of two times per week
• Several times per month
• Once a month
• Less frequent

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Proposed items for measuringpain and discomfort
(cont.)

• MED_PAIN Have you used any medication to try to
  ease (the) pain during this period?
• No
• Daily
• Now and again
• INTENS_PAIN Thinking about the last time you
  had pain On a scale from 1-100 how intense was
  the pain 0 is no pain and 100 is the worst pain
  imaginable.

worst pain imaginable
No pain
100
0
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Pain Characteristics of Proposed Questions

• Filter Question
• Used
• Assistive Devices
• Information obtained on use of pain meds
• Questions on frequency and intensity do not
  specify whether pain meds are used
• Recall period/chronicity
• Intent is to limit to chronic or recurrent pain
  but not specified or defined
• Recall period is used but length of period not
  yet specified for ever having pain and frequency
  of pain
• Most recent episode for intensity of pain
• Response categories
• Frequency Labeled categories all the time
  to less frequent
• Intensity Scale from 1 to 100
• Severity
• Measured for frequency and intensity