What do patients expect from their first visit to a pain clinic?

Objective: To examine patients' expectations of their first outpatient visit to a pain clinic. We asked patients what would be the most satisfying and the most disappointing outcomes of their visit and whether they expected changes in medication and further investigations to result from their consultation.

Design: Patients completed questionnaires and a structured interview to assess expectations before their clinic appointment.

Chronic pain, relationships and illness self-construct.

A standardised illness self-construct repertory grid was used to evaluate relationships between people with chronic pain and the person to whom they felt closest. The 'Closest Other' was used to evaluate a wider range of relationships than generally included in research on 'spouse' reactions to chronic pain. The illness self-construct repertory grid indicated that closest others tended to place illness more centrally in the life of the individual with pain than did the person who had pain.

Follow-up results from a randomised controlled trial evaluating in- and outpatient pain management programmes.

This study reports a 9-18 month follow-up of a randomised controlled trial of pain management programmes for chronic, non-malignant pain. Twenty-two inpatients, 18 outpatients and 12 control subjects completed the follow-up assessments. Significant treatment effects were demonstrated by the inpatient group on pain ratings, the Pain Behaviour Checklist, and General Health Questionnaire, with similar effects demonstrated by the outpatient group on the former 2 measures.

Epidemiology of pain in New Zealand.

Information on the prevalence of pain in the general population has relevance for the allocation of health services and for understanding of chronic pain. In 1986 a sample of 1498 adults were interviewed using the Diagnostic Interview Schedule. Questions on pain were taken from the somatisation section of the interview schedule.

A randomised control trial evaluating in- and outpatient pain management programmes.

This study investigated the clinical efficacy of in- and outpatient pain management programmes in comparison with a control group. Following physical examination and psychosocial assessments, and after obtaining informed consent, patients were randomly assigned to 1 of 3 groups: (1) a 4 week multidisciplinary inpatient pain management programme; (2) a 9 week (2 h/week) multidisciplinary outpatient programme; or (3) a control group. Self-report, behavioural and physiological measures were taken pre and post treatment.

Personalized evaluation of self-hypnosis as a treatment of chronic pain: a repertory grid analysis.

Self-hypnosis was taught to 5 highly hypnotisable patients referred to Auckland Hospital Pain Clinic. Evaluation included the Illness Self-Concept Repertory Grid (ISCRG) and follow-up was at 1 and 6 months post treatment. Consensus grids indicated the subjects initially identified with physical illness but this association decreased over the course of the study.

Self-concepts and illness attitudes in chronic pain. A repertory grid study of a pain management programme.

Four patients completed a 10-session out-patient pain management programme which included didactic information, relaxation training and cognitive-behavioural techniques. At the beginning and completion of the programme a number of measures were taken, including symptom inventories and a repertory grid designed to tap the patients' self-concepts and attitudes towards illness. These two sets of before and after measures were compared.

Prediction of treatment response in pain patients: the illness self-concept repertory grid and EMG feedback.

Eighteen patients with chronic musculoskeletal pain completed a trial of EMG feedback where each subject was exposed to biofeedback, a control condition and a waiting list. Pain scores were determined pre- and posttrial, and the percentage change calculated for each subject. EMG activity and present pain measured during the trial gave an EMG/pain correlation for each patient.

Electromyographic (EMG) feedback in chronic musculoskeletal pain: a controlled trial.

The literature regarding the application of EMG feedback training in musculoskeletal pain disorders is reviewed. A within-subject control trial of EMG feedback using a counterbalanced design in patients with chronic musculoskeletal pain is reported here. Eighteen subjects (12 females and 6 males) were studied in terms of subjective reports of pain and EMG activity measurement under standardised conditions.

Illness behaviour profiles in chronic pain: the Auckland experience.

Two hundred patients with chronic pain, presenting to the Auckland Hospital Pain Clinic, completed the illness behaviour questionnaire (IBQ) developed by Pilowsky and Spence in Adelaide. These authors have identified 6 taxonomic clusters from a numerical analysis of illness behaviour profiles and have described the characteristics of these groups of patients. This study reports the results of a similar analysis of IBQ scores taken from a larger group of patients and clustered using a variant of the K-means algorithm.

The psychiatrist and the chronic pain patient: 172 anecdotes.

The clinical experience of a psychiatrist working in a pain clinic is described. One hundred and seventy two patients were assessed over a 4-year period. The modal age was 45-54 years with a male : female ratio of 7 : 10.