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PAIN QUESTIONNAIRE English for dd otalgia

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PAIN QUESTIONNAIRE English for dd otalgia Powered By Docstoc
					                                     PAIN QUESTIONNAIRE
      Name ________________________________                        F ___ M ___ DOB _____
      Occupation ___________________________                       Date __________________

      Please tick (√) blank spaces indicated, and give appropriate details as required.
      Answers to the following questions are for our records only and are strictly confidential.

       1. When did the pain start?
          _____________________________________________________________
       2. How did the pain start?
          _______ Suddenly ______ Progressed slowly
       3. Where is the pain located?
          ___ Head ___ Neck ___ Chest ___ Abdomen        Other _________________
          ___ Top ___ Front ___ Back ___ Side ___ All over
       4. How long does the pain last?
          ___ Minutes     ___ Hours              ___ Days         ___Weeks         ___ Months
       5. Does / Did the pain begin in one place and spread to other areas?
          ___ Yes      ___ No
          If so, which area? _______________________________________________
       6. How often does the pain recur?
          ___ Constantly     ___ times daily             ___ times weekly
       7. How severe is the pain?
          ___ Mild       ___ Moderate       ___ Severe         ___ Very severe
          Does it interfere with your work, daily activities, sports? ___ Yes ___ No
       8. What is the pain like? Use your own words to describe it.
          _____________________________________________________________
       9. When does the pain occur?
          ___ Mornings      ___ Afternoons     ___ Evenings    ___ Nights
          ___ Weekdays      ___ Weekends      ___ Holidays    ___ During work
          ___ While resting    ___ Before meals    ___ After meals
          Other circumstances _____________________________________________
      10. Are there any other symptoms associated with the pain? Give details.
          _____________________________________________________________
          _____________________________________________________________
      11. Does anyone in your family have any pain? ___ Yes ___ No
          If so, who? ____________________________________________________
          Explain _______________________________________________________
      12. Have you recently had any of the following?
          ___ rash     ___ fever     ___ infection              ___ injury       ___ operation



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        It is also possible to ask the patient to indicate on the scale
         presented below the degree of pain she/he is experiencing.

0         1       2       3        4       5        6        7      8       9       10
No              Mild              Moderate                 Severe                  Pain as
pain                                                                                bad as
                                                                                    it can
                                                                                        be

The Wong/Baker Faces Rating Scale is used especially with children. You explain to
the child that each face is for a person who feels happy because she/he has no pain,
or feels sad because she/he has pain.

     Point to face 0 and tell the child what it is showing.

“This face is very happy because she (he) doesn’t hurt at all.”

     Now point to faces 1, 2, 3, 4 and , choosing an appropriate comment.




a.   “hurts just a little bit.”
b.   “hurts as much as you can imagine, but you don’t have to be crying to feel this bad.”
c.   “hurts a little more.”
d.   “hurts a whole lot.”
e.   “hurts even more.”

     Finally, ask the child to choose the face which best describes how they
     feel.




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           WORd FORmATION

           1     What do these terms describing pain mean? Identify and
                 describe briefly the following pains, then find out the matching
                 definitions and give the corresponding Polish terms.
      Example: dys- = painful -algia, -dynia = pain

      1.   arthralgia                       7.   myalgia
      2.   brachialgia                      8.   neuralgia
      3.   cephalalgia                      9.   osteodynia / ostealgia
      4.   causalgia                       10.   otalgia
      5.   dysmenorrhoea                   11.   polymyalgia
      6.   dysuria
                                                    Medical term                     Polish term

       1.      pain in several muscle groups        ..............................   ..............................
       2.      pain on passing water / urination    ..............................   ..............................
       3.      pain in the bone                     ..............................   ..............................
       4.      muscular pain                        ..............................   ..............................
       5.      severe pain along the course of
               a nerve or nerves                    ..............................   ..............................
       6.      painful menstruation                 ..............................   ..............................
       7.      severe pain in a joint               ..............................   ..............................
       8.      earache                              ..............................   ..............................
       9.      headache                             ..............................   ..............................
      10.      pain in the arm                      ..............................   ..............................
      11.      burning pain in a limb caused
               by a nerve damage                    ..............................   ..............................


           2     Give english terms for the following.
      1.   ból ucha
      2.   ból ramienia
      3.   ból wielomięśniowy
      4.   nerwoból
      5.   ból kości
      6.   mięśnioból
      7.   ból stawu
      8.   bolesne oddawanie moczu
      9.   bolesne miesiączkowanie



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   mORe ReAdING
   Read the table and answer the questions that follow.

Headache (cephalgia, cephalalgia)
Headache is one of the most common symptoms, disabling both women and men.
Some people suffer frequent headaches, others are rarely affected. The following table
demonstrates a few selected types of headaches.

            Type/Cause                                Pain characteristics

migraine headache                   age: usually between 10 and 40 yrs
                                    gender: more frequent in women; remits after age 50
                                    yrs
                                    a family history in over 50% of patients
                                    lasts 4 to 72 h
                                    moderate to severe
                                    throbbing
                                    unilateral
                                    aggravated with exertion
                                    associated with N&V, sensitivity to light, sound, or smell
                                    preceded by:
                                    – a short prodromal period of depression, irritability,
                                       restlessness, or anorexia
                                    – an aura: disturbed balance, speech, or vision (flashing
                                       lights and scotomas)
                                    – attacks occur daily or once every several wks, mo or
                                       yrs


Cluster headache                    lasts 15 min to 3 h
                                    very severe
                                    piercing
                                    unilateral
                                    periorbital
                                    occurs up to 8 times/d


Hypertension                        throbbing
                                    occurs in spasms
                                    back and top of the head


Sinusitis                           severe
                                    acute: lasts a short time
                                    gradual: persistent
                                    dull or sharp
                                    frontal
                                    more severe a.m. and less severe p.m.
                                    aggravated in cold, damp weather, on lying down




                                                                                                 113
      Brain tumour                         mild to severe
                                           progressively increasing
                                           increasingly recurrent, eventually constant
                                           without relief
                                           more severe when the pt lies down
                                           awakens the pt from sleep
                                           worse on awakening


      Glaucoma                             moderate or severe
                                           increased after using the eyes
                                           frontal, or ocular



      meningitis                           severe
                                           constant
                                           experienced in the “whole head”
                                           radiates down the neck
                                           stiff neck difficult to bend
                                           fever
                                           vomiting



      Subdural haematoma                   mild to severe
                                           intermittent or constant
                                           experienced in one site or diffuse
                                           radiates down the neck



      Subarachnoid haemorrhage             severe, “the worst ever”
                                           constant
                                           widespread
                                           occasionally, intra- and periorbital
                                           unilateral
                                           ptosis of the eyelid




       1.   Which of these headaches affects one sex more often than the other?
       2.   Which are felt in one side of the head only?
       3.   In what cases does the headache become worse when the patient lies down?
       4.   In what conditions is the pain in the head more severe in the morning?
       5.   In what conditions does the patient point to his/her eye or around the eye
            when the doctor asks Where does it hurt?
       6.   How is loss of appetite related to migraine?
       7.   When is the headache associated with drooping of the upper eyelid?
       8.   Which of the headaches spread to other parts of the body?
       9.   When is vomiting an accompanying complaint?
      10.   Which of the headaches described seems to be the most severe?



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