Get documents about "PAIN QUESTIONNAIRE English for dd otalgia
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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
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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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