Physiological Measure of Pain: Heart Rate Variability

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Classification of Pain

Some argue that due to the subjectivity of pain, forming classification systems may be impossible or simply undesirable (Merskey, 2007). Nonetheless, the benefits of having such classification systems in the field of pain are clear. Classifying pain based on its duration is found to provide vital information into the characteristics of one‘s experience of pain and provide a guideline of how the pain can be addressed.

Transient Pain

Individuals usually experience minor day-to-day sensations of pain which do not cause prolonged physical or emotional discomfort, and disappear quickly. Transient pain is characterised by initially being well defined and mild then intensifying for a few seconds with sensations such as throbbing or stabbing, and then quickly subsiding (Melzack & Wall, 1982). This type of pain is seldom associated with any real physiological consequence. In addition, no real demand is placed on an individual’s attention and daily functioning is rarely affected (Loeser & Melzack, 1999; Melzack & Wall, 1982) .

Acute pain

Acute pain differs from transient pain in that it lasts longer and usually causes a temporary hindrance in day-to-day functioning. It is typically associated with some form of injury or tissue damage and may be anxiety provoking (Melzack & Wall, 1982). From a functional perspective, acute pain can act as an indicator of injury and consequently draws ones attention to the injury. It also prompts protective behaviours such as avoidance of excessive motion of the injured area which facilitates healing (Carr & Goudas, 1999). Acute pain is usually alleviated with simple pain remedies and only lasts the duration of the corresponding injury. Acute pain influences, and is influenced by affect. This plays a role in how one defines the biological significance of the injury and what they attribute their injury to. In addition, acute pain can promote learning, by acting as an incentive to avoid future injury (Chapman & Stillman, 1996; Gatchel & Maddrey, 2004; Melzack & Wall, 1982). Acute pain can sometimes persist until its functional characteristics are no longer beneficial and can cause significant amounts of suffering and functional impairment, such as in chronic pain.

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Chronic pain

Pain can persist beyond the normal time of healing of an injury, or of any useful function. The IASP (1994) define chronic pain as the subjective experience of persistent pain, in the absence of biomedical indicators such as tissue damage, or beyond the point of predicted healing. Chronic pain has generally been recognised as when pain persists beyond three to six months after an injury (New Zealand Ministry of Health [NZMoH], 2008). When pain becomes chronic, it can have long-term negative impacts on the sufferer‘s day to day living.
However, often it is not only the pain itself that causes such debilitation, but also the myriad cognitive, behavioural, and physiological factors that commonly accompany it (Craig & Versloot, 2011). These factors contribute to why chronic pain conditions can have such debilitating effects in all facets of life including social function (e.g. withdrawal from social activities; Youssef, Atienza, Langseder, & Strauss, 2008), physical function (e.g. decreased mobility; Bishop, Meuleman, Robinson, & Light, 2007), psychological function (e.g. anxiety;  Asmundson, Abrams, & Collimore, 2008; and depression; Bair, Robinson, Katon, & Kroenke, 2003) and can significantly reduce ones quality of life (Hunfeld et al., 2001; Wagner, Stenehjem, & Stanghelle, 1995).

Chapter One: Pain: An Introduction
1.1. Defining Pain
1.3. Classification of Pain
1.4. Summary
Chapter Two: The Multidimensional nature of Pain
2.1. Psychosocial Factors.
2.2 Individual Factors
2.3 Summary
Chapter Three: Physiological Measure of Pain: Heart Rate Variability
3.1. Defining Heart Rate Variability
3.2. Theoretical Underpinnings
3.3. Individual Factors Influencing Heart Rate Variability.
3.4 Heart Rate Variability and Pain
3.5 Summary
Chapter Four: Proposed Study, Study Design and Hypotheses
4.1. Proposed Study
4.2. Aims
4.3. Study Design
4.4. Hypotheses
Chapter Five: Method
Chapter Six: Results
Chapter Seven: Discussion
References.

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Maori, Pacific, and European Differences in Response to Pain and Worry

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