Interdisciplinary pain assessment of spinal cord injury patients

Abstract

The purpose of "Interdisciplinary Pain Assessment of Spinal Cord Injury Patients," a model project funded by the American Association of Spinal Cord Injury Nurses, was to evaluate the McGill-Melzack Pain Questionnaire (MMPQ) for effectiveness in assessing pain in persons with spinal cord injury (SCI). Currently, the MMPQ is the instrument of choice for assessment of pain; however, normative psychometric data for use of the MMPQ for SCI related pain does not exist. Specifically, the research question addressed was "does the MMPQ adequately assess pain in patients with altered neurological pathways due to SCI?" To answer this question, an integrated literature search was conducted to identify pain characteristics of SCI-related pain types for comparison with the MMPQ pain characteristics in order to determine initial generlizability of the MMPQ to the seven defined SCI pain types. Secondly, 27 subjects with SCI (9 quadriplegic and 18 paraplegic subjects) were admitted voluntarily to the study over a five month interval. All subjects were asked to independently describe their pain, and locate their pain on a blank human body diagram, complete the MMPQ, and rate their pain severity by use of the pain visual graphic rating scale. Then MMPQ was determined to adequately present SCI pain adjectives. Overall, the MMPQ does provide a systematic framework for comprehensive assessment for the types of pain associated with SCI patients. Based on the findings of this study with a limited sample size, the MMPQ did differentiate pain experience by patients who are quadriplegic or paraplegic. The detailed procedure and results of this model project are presented in this article.