Abstract:
BACKGROUND:Inadequate pain assessment is a barrier to appropriate pain management, but single-item "pain screening" provides limited information about chronic pain. Multidimensional pain measures such as the Brief Pain Inventory (BPI) are widely used in pain specialty and research settings, but are impractical for primary care. A brief and straightforward multidimensional pain measure could potentially improve initial assessment and follow-up of chronic pain in primary care. OBJECTIVES:To develop an ultra-brief pain measure derived from the BPI. DESIGN:Development of a shortened three-item pain measure and initial assessment of its reliability, validity, and responsiveness. PARTICIPANTS:We used data from 1) a longitudinal study of 500 primary care patients with chronic pain and 2) a cross-sectional study of 646 veterans recruited from ambulatory care. RESULTS:Selected items assess average pain intensity (P), interference with enjoyment of life (E), and interference with general activity (G). Reliability of the three-item scale (PEG) was alpha = 0.73 and 0.89 in the two study samples. Overall, construct validity of the PEG was good for various pain-specific measures (r = 0.60-0.89 in Study 1 and r = 0.77-0.95 in Study 2), and comparable to that of the BPI. The PEG was sensitive to change and differentiated between patients with and without pain improvement at 6 months. DISCUSSION:We provide strong initial evidence for reliability, construct validity, and responsiveness of the PEG among primary care and other ambulatory clinic patients. The PEG may be a practical and useful tool to improve assessment and monitoring of chronic pain in primary care.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Krebs EE,Lorenz KA,Bair MJ,Damush TM,Wu J,Sutherland JM,Asch SM,Kroenke Kdoi
10.1007/s11606-009-0981-1subject
Has Abstractpub_date
2009-06-01 00:00:00pages
733-8issue
6eissn
0884-8734issn
1525-1497journal_volume
24pub_type
杂志文章abstract:BACKGROUND:Medical management of acute pain among hospital inpatients may be enhanced by mind-body interventions. OBJECTIVE:We hypothesized that a single, scripted session of mindfulness training focused on acceptance of pain or hypnotic suggestion focused on changing pain sensations through imagery would significantl...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-017-4116-9
更新日期:2017-10-01 00:00:00
abstract::This report examines alternative methods of paying for clinical preventive care services. First, the extent of coverage of preventive health care services in public and private health insurance plans is reviewed. Included in this review are Medicare, Medicaid, health maintenance organizations, and private health insur...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Few studies have examined the impact of inpatient interpreter use for limited English proficient (LEP) patients on length of stay (LOS), 30-day post discharge emergency department (ED) visits and 30-day hospital readmission rates for LEP patients. METHODS:A retrospective cohort analysis was conducted of all...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3213-x
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To quantify the magnitude of general medical and/or pharmacy claims expenditures for individuals who use behavioral health services and to assess future claims when behavioral service use persists. DESIGN:Retrospective cost trends and 24-month cohort analyses. SETTING:A Midwest health plan. PARTICIPANTS:Ov...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.40099.x
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Guidelines recommend administration of antibiotics with activity against methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa for treatment of healthcare-associated pneumonia (HCAP). It is unclear if this therapy improves outcomes for patients with HCAP. OBJECTIVE:To determine if ad...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-012-2011-y
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Interpreter services for medical care increase physician-patient communication and safety, yet a "formal certification" process to demonstrate interpreter competence does not exist. Testing and training is left to individual health care facilities nationwide. Bilingual staff are often used to interpret, with...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0344-8
更新日期:2007-11-01 00:00:00
abstract::We describe a half-day workshop to teach third-year medical students three focused end-of-life care skills: breaking bad news, discussing advance directives, and assessing and managing pain. Our workshop included a readers' theater exercise and three role-play exercises. In two of the workshops, faculty members played...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2004.30115.x
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Despite the benefits of influenza vaccination, each year more than half of adults in the United States do not receive it. OBJECTIVE:To evaluate the association between an active choice intervention in the electronic health record (EHR) and changes in influenza vaccination rates. DESIGN:Observational study....
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-017-4046-6
更新日期:2017-07-01 00:00:00
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doi:10.1007/s11606-019-04882-2
更新日期:2019-05-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1007/s11606-017-4161-4
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Changes to national guidelines for breast and cervical cancer screening have created confusion and controversy for women and their primary care providers. OBJECTIVE:To characterize women's primary health care provider attitudes towards screening and changes in practice in response to recent revisions in gui...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-015-3449-5
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Use of electronic health records (EHRs) is associated with physician stress and burnout. While emergency departments and subspecialists have used scribes to address this issue, little is known about the impact of scribes in academic primary care. OBJECTIVE:Assess the impact of a scribe on physician and pati...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4434-6
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Post-hospital discharge follow-up appointments are intended to evaluate patients' recovery following a hospitalization, but it is unclear how appointment statuses are associated with readmissions. OBJECTIVE:To examine the association between post-discharge ambulatory follow-up status, (1) having a scheduled...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06569-5
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:With the reorganization of primary care into Patient Aligned Care Teams (PACT) teams, the Veteran Affairs Health System (VA) aims to ensure all patients receive care based on patient-centered medical home (PCMH) principles. However, some patients receive the preponderance of care from specialty rather than p...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2677-9
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To determine whether depressive symptoms measured at baseline are associated with mortality and to describe the course of depressive symptoms and their relation to physical decline in patients over a 6-year period. DESIGN:Prospective cohort study conducted from 1990 through 1996. SETTING:Urban academic prim...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00226.x
更新日期:1998-11-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599668
更新日期:1995-03-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0336-8
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Rates of preventable admissions will soon be publicly reported and used in calculating performance-based payments. The current method of assessing preventable admissions, the Agency of Healthcare Research and Quality (AHRQ) Preventable Quality Indicators (PQI) rate, is drawn from claims data and was original...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3615-4
更新日期:2016-06-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-007-0254-9
更新日期:2007-09-01 00:00:00
abstract::Emergency readmissions among patients discharged from the medical service of an acute-care teaching hospital were analyzed. Using the multivariate technique of recursive partitioning, the authors developed and validated a model to predict readmission based on diagnoses and other clinical factors. Of the 4,769 patients...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596366
更新日期:1987-11-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 社论
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更新日期:2020-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02597402
更新日期:1989-07-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-018-4548-x
更新日期:2018-11-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1999.00306.x
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:The patient-centered medical home (PCMH) has clinical benefits for chronic disease care, but the association with patient-reported outcomes such as health-related quality of life (HRQoL) is unexplored in patients with multimorbidity (two or more chronic diseases). OBJECTIVE:To examine if greater clinic-leve...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05429-1
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Developing a definition of what constitutes high need among Medicare beneficiaries using administrative data is an important prerequisite to evaluating value-based payment reforms. While various definitions of high need exist, their predictive validity for different patient outcomes in the following year has...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4781-3
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To review the current information on medical complications, psychological implications, and legislative issues related to body piercing, a largely unregulated industry in the United States. METHODS:We conducted a MEDLINE search of English language articles from 1966 until May 1998 using the search terms "bod...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1046/j.1525-1497.1999.00357.x
更新日期:1999-06-01 00:00:00
abstract:PURPOSE:Studies show that measures of physician and medical students' empathy decline with clinical training. Presently, there are limited data relating self-reported measures to observed behavior. This study explores a self-reported measure and observed empathy in medical students. METHOD:Students in the Class of 200...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-1193-4
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not b...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3405-4
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Many have called for ambulatory training redesign in internal medicine (IM) residencies to increase primary care career outcomes. Many believe dysfunctional, clinic environments are a key barrier to meaningful ambulatory education, but little is actually known about the educational milieu of continuity clini...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1437-3
更新日期:2011-01-01 00:00:00