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NIH grant funds study on language of pain

By Lesli Hicks
Special Projects Writer, UTSA '07

(Sept. 7, 2007)--UTSA Professor Ephrem Fernandez will lead a research team from UT Southwestern Medical Center in Dallas, the UT Health Science Center at San Antonio with physicians from various pain clinics and UTSA researchers and students to learn more about pain, a powerful symptom found in many medical conditions.

"It is the second most common reason why people seek medical attention," said Fernandez, professor of psychology in the College of Liberal and Fine Arts and the recent recipient of a $368,711 two-year grant from the National Institutes of Health. The NIH grant for the project, "Psychometric Properties and Diagnostic Utility of the Pain Descriptor System," will research the language of pain, which could help guide caregivers to better diagnoses and treatment.

"Typically, the two questions that the physician or nurse asks of a person in pain are 'Where is the pain?' and 'What does the pain feel like?'" Fernandez said. Their replies go beyond immediate patient complaints and actually are long-term clues to helping clinicians heal them.

For example, complaints of "throbbing" or "pulsing sensation" are more consistent with vascular properties of migraine, while a "dull ache" is in keeping with a tension headache.

"There are also words to convey a diversity of emotional qualities associated with pain," Fernandez said. The adjective "terrifying" suggests a high level of anxiety, "miserable" suggests depression and "annoying" conveys a low level of anger, he said.

Drawing largely from patient interviews, the Fernandez group will identify, classify and calibrate pain descriptors to help differentiate pain in areas such as the back, head, joints and nerves, also relating it to disability levels and to demographic variables such as gender. The anticipated result will be a new "psychometrically valid and reliable" diagnostic test that can be used in conjunction with other instruments for assessing pain.

The significance of the team's work is raised by the recognition that, nationwide, approximately 25 million people suffer acute pain from surgery or accidents, and some 50 million live with chronic pain from disease, disorder or accident. Worldwide, such pain affects one in five people -- sadly, mostly those living in low- and middle-income countries.

Concern for community health and rising medical and insurance costs are why the American Pain Society and its peers have declared pain as a fifth "vital sign" requiring routine assessment along with pulse, blood pressure, respiration and body temperature.

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