title: Chronic pain and the development of a symptom checklist: a pilot study.
abstract: BACKGROUND
  There is currently no instrument to systematically assess the range of symptoms/problems and their bothersomeness in patients with chronic non-cancer pain (CNPN). Systematic assessment and prioritizing may target treatments and improve outcomes.
  
  
  METHODS
  The authors developed a checklist of symptoms and problems, the Copenhagen Symptom Checklist (CSC), presented clinically by patients. Fifty-three items representing biological, psychological and social areas were selected. Symptom/problem severity was rated on a 5-point scale anchored at 0 = 'not at all' and 4 = 'severe'. Patients ranked the five most bothersome symptoms/problems and could add five open-ended items. Patients completed the CSC after the first visit at the multidisciplinary pain centre.
  
  
  RESULTS
  One hundred and twelve consecutive patients completed the CSC. Eighty-nine percent scored pain as rather severe or very severe (score = 3 plus score = 4), followed by reduction in physical activity (67%), fatigue (66%) and sleep disturbance (53%). Pain and fatigue, but not reduction in physical activity, were given highest priority. Cognitive problems were important to a third of the patients. Depressive symptoms, cognitive problems and worry explained 17.5% of the total variance. Patients filled in the CSC without important loss of information, but a minority prioritized more than three areas or used the free text alternative.
  
  
  CONCLUSIONS
  Patients prioritized pain and fatigue as the most burdensome symptoms, but reduction in physical activity and sleep problems were also highly ranked. Patients were positive to the idea of symptom reporting; however, the 53-item number in this version of CSC is larger than may be necessary.
authors.affiliation: Rehabilitation Medicine Clinic, Orebro, Sweden. sally.kendall@rh.regionh.dk
authors.forename: S
authors.initials: S
authors.lastname: Kendall
authors.forename: N R
authors.initials: NR
authors.lastname: Holm
authors.forename: J
authors.initials: J
authors.lastname: Højsted
authors.forename: L
authors.initials: L
authors.lastname: Frich
authors.forename: P
authors.initials: P
authors.lastname: Rotbøll Nielsen
authors.forename: N-H
authors.initials: NH
authors.lastname: Jensen
authors.forename: P
authors.initials: P
authors.lastname: Sjøgren
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy / Q000209:etiology; D057189:Checklist; D059350:Chronic Pain / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010865:Pilot Projects; D011788:Quality of Life; D012720:Severity of Illness Index; D020919:Sleep Disorders, Intrinsic / Q000188:drug therapy / Q000209:etiology; D063189:Symptom Assessment / Q000379:methods*
chemical_list: D000700:Analgesics; D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives