Outcomes measurement in pain management: issues of disease complexity and uncertain outcomes.
Pain is a complex disease process. Pain management requires an interdisciplinary rather than a multidisciplinary clinical intervention, interdisciplinary because the factors that may affect pain intensity and duration occur simultaneously. A particular problem exits when measuring outcomes from chronic diseases, disorders, and impairments because neither a cure nor death is a likely outcome. The clinical and psychosocial determinates of pain complicate the assessment of level of pain and the measurement of pain management outcomes. The major obstacle to assessing change from a pain intervention is the lack of a gold standard. Because we have no gold standard for better functional health, our evaluation of the responsiveness of health status measures regarding pain management will continue to be plagued with the question "responsive to what"?
Goodman
Gerald R
GR
Health Care Administration, Texas Woman's University, Houston, Tex 77030, USA. ggoodman@twu.edu
D000328:Adult; D006304:Health Status; D006801:Humans; D007591:Joint Commission on Accreditation of Healthcare Organizations; D008875:Middle Aged; D010146:Pain / Q000145:classification / Q000453:epidemiology; D059408:Pain Management; D010147:Pain Measurement; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology