PhD ceremony Mr. J.J. Meeuse: Aspects of pain in measurement, management and health care utilization
|When:||We 11-09-2013 at 14:30|
PhD ceremony: Mr. J.J. Meeuse, 14.30 uur, Academiegebouw, Broerstraat 5, Groningen
Dissertation: Aspects of pain in measurement, management and health care utilization
Promotor(s): prof. R.O.B. Gans
Faculty: Medical Sciences
This thesis describes various aspects of pain. It aims to contribute to improve pain measurement, treatment, and the relationship between pain and health care consumption.
To develop an instrument for patients who are not able to indicate their pain intensity, the association between heart rate variability with pain intensity was studied in 75 healthy volunteers. Although changes occurred in heart rate variability during pain, these changes were not correlated with the perceived pain intensity.
Radiotherapy is effective for painful bone metastases. Since pain relief is not always immediate and is sometimes preceded by an increase in pain, we examined whether radiotherapy is useful in patients with a short life expectancy. In a subanalysis of 274 patients from the Dutch Bone Metastases Study, who deceased within 12 weeks after radiotherapy, 45% showed a decrease in pain. Nonetheless, in 60% of them the pain remained moderate to severe.
The hypothesis that people experience less pain if they are distracted, eg by music, was studied in 245 patients who underwent sigmoidoscopy. Whether or not you listen to music did not affect the perceived pain intensity.
Care during the last weeks of life is preferably provided at the patients’ home, according to the Dutch model. In a subanalysis of the Dutch Bone Metastases Study we found, that during these weeks an increase in GP contacts was not accompanied with a reduction in hospital based care. A transmural multidisciplinary palliative team may help to avoid unnecessary hospital visits.