Investigating and describing the nature of pain

Exercise 1. First, discuss with your colleagues:

1. What kind of patients are more likely to do the following and why?
a. Say the pain is greater than it is
b. Say the pain is less than it is
2. Why is it important for the patient to be able to describe pain accurately?
3. How do YOU react to pain?

Exercise 2. Create an English-Romanian/Romanian-English mini-dictionary of adjectives describing pain,

including the ones below. Next to each, think of a health problem corresponding to each adjective (e.g.
migraine = blinding headache)
 1. Blinding 5. Gripping 9. Tingling
2. Burning 6. Pounding 10. Throbbing
3. Cramping 7. Shooting 11. (feel free to add more)
4. Crushing 8. Stabbing

Exercise 3. There are 7 attributes of a symptom which the doctor should pay attention to. In order to carry out
a holistic, patient-centred encounter, an 8th attribute should be added to the list. What might it be?
1. Location
2. Quality
3. Quantity/severity
4. Timing
5. Setting (in which it occurs)
6. Aggravating/alleviating
7. Associated manifestations
8. ???

Exercise 4. A young mother and her son are being interviewed about some hay-fever-type symptoms. Here are
some of the questions the doctor poses. Categorize them (more than one category may be possible for each
question):

C = closed question, L = leading question, M = multiple questioning, T = tag question

1. Does the sneezing start when the dog is in the house?

2. Has he been wheezing as well?
3. So the symptoms are there all the time, arent they?
4. Is he getting these attacks while hes outside, too? Do they come on suddenly with no warning? What
typically happens?
5. Did your sons allergy start after you bought the dog?
6. And youve already taken him to see your GP about this problem, havent you?

With your colleagues, clarify what these categories of questions mean and decide which are likely to be more
effective. Rewrite some of the questions to make them more effective.

Exercise 5. Not all patients are capable of describing pain and different degrees of pain. How can the doctor
help the patient provide complete and accurate information about their experience with pain?