Abstract
The current scoping review aimed to map current literature investigating the relationship between pain extent extracted from pain drawings with clinical, psychological, and psycho-physiological patient-reported outcome measures in people with pain. Electronic databases were searched for cross-sectional cohort studies that collected pain drawings using digital technology or a pen-on-paper approach and assessed for correlations between pain extent and clinical, psychological or psycho-physical outcomes. Data were extracted by two different reviewers. The methodological quality of studies was assessed using the Newcastle–Ottawa Quality Assessment Scale. Mapping of the results included: 1, description of included studies; 2, summary of results; and 3, identification of gaps in the existing literature. Eleven cross-sectional cohort studies were included. The pain disorders considered were heterogeneous, ranging from musculoskeletal to neuropathic conditions, and from localized to generalized pain conditions. All studies included pain and/or pain-related disability as clinical outcomes. Psychological outcomes included depression and anxiety, kinesiophobia and catastrophism. Psycho-physical measures included pressure or thermal pain thresholds. Ten studies were considered of high methodological quality. There was heterogeneity in the associations between pain extent and patient-reported outcome measures depending on the pain condition. This scoping review found that pain extent is associated with patient-reported outcome measures more so in patients presenting with musculoskeletal pain, e.g., neck pain or osteoarthritis, rather than for those with neuropathic pain or headache.
Highlights
A pain drawing (PD) is a self-report measure that helps patients to communicate the location and extent of their symptom
The research question was defined in order to highlight the possible clinical significance and the diagnostic utility of pain extent obtained from the PD
The findings revealed that larger pain extent was significantly associated with: 1
Summary
A pain drawing (PD) is a self-report measure that helps patients to communicate the location and extent of their symptom. PDs together with other patient-reported outcome measures, for example, questionnaires capturing physical function or quality of life. Harold Palmer in 1949 proposed PDs as a tool to visualize the patient’s pain experience and to support clinicians to differentially diagnose between “psychological pain” and “organic pain” [1]. Pain drawings or pain charts are different terms used to describe a similar procedure which is to obtain a topographical description of the patient’s pain symptoms using a body chart (i.e., stereotypical image of the body) [2]. A combination of PDs and qualitative or quantitative descriptors have been proposed for a multidimensional evaluation of pain experience, e.g., McGill Pain Questionnaire [4]
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