Transcript Working Paper No.3 Add.4 11 November 2005 STATISTICAL COMMISSION and UN ECONOMIC COMMISSION FOR EUROPE STATISTICAL OFFICE OF THE EUROPEAN COMMUNITIES (EUROSTAT) CONFERENCE OF EUROPEAN STATISTICIANS WORLD HEALTH ORGANIZATION (WHO) Joint UNECE/WHO/Eurostat.

Working Paper No.3 Add.4
11 November 2005
STATISTICAL COMMISSION and
UN ECONOMIC COMMISSION FOR
EUROPE
STATISTICAL OFFICE OF THE
EUROPEAN COMMUNITIES
(EUROSTAT)
CONFERENCE OF EUROPEAN
STATISTICIANS
WORLD HEALTH
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 Madans
National Center for Health Statistics, U.S.A
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
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
Proposed items for measuring
pain 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/months): 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
Proposed items for measuring
pain 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.
No pain
0
worst pain imaginable
100
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