Clinical Investigation

Kidney International (1982) 21, 840–848; doi:10.1038/ki.1982.108

Pain, control over treatment, and compliance in dialysis and transplant patients

Yitzchak M Binik1, Andrew G Baker1, Dennis Kalogeropoulos1, Gerald M Devins1, Ronald D Guttmann1, David J Hollomby1, Paul E Barré1, Tom Hutchison1, Michel Prud'Homme1 and Lise McMullen1

1Department of Psychology and Faculty of Medicine, McGill University, Transplantation Service and Department of Medicine, Royal Victoria Hospital, and Nephrology Service, Notre Dame Hospital, Montreal, Canada

Correspondence: Dr Y M Binik, Department of Psychology, McGill University, 1205 Dr. Penfield Ave., Montreal, PQ H3A 1B1, Canada

Received 8 July 1981; Revised 30 November 1981.

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Abstract

Pain, control over treatment, and compliance in dialysis and transplant patients. Pain was surveyed via structured interview and the McGill Pain Questionnaire in 53 dialysis and 27 transplant patients. Increased patient control over the dialysis procedure was not associated with a reduction in pain though perceived control may have been. Compliance with the dialysis regimen did not predict pain and the validity of the category "dialysis headache" was questioned. Overall, transplant recipients did not report significantly less pain than dialysis patients. Self-reported depression was correlated positively with pain. The clinical implications of these findings are discussed.

Les douleurs, le contrôle thérapeutique et l'adaptation chez des malades dialysés et transplantés. Une étude de la douleur a été entreprise chez 53 dialysés et 27 transplantés au cours d'entretiens, et à l'aide d'un questionnaire (McGill Pain Questionnaire). Une plus grande participation du malade à la dialyse n'allait pas de pair avec une réduction des douleurs, alors que le contrôle perçu peut avoir eu cet effect. Une bonne adaptation à la dialyse ne permettait pas de prédire les douleurs, et la validité de la classification "céphalées au cours de dialyses" a été remise en question. D'une façon générale, les transplantés n'indiquaient pas des douleurs significativement inférieures à celles des dialysés. L'état dépressif rapporté par les malades était positivement corrélé avec les douleurs. Les implications cliniques de ces résultats sont discutées.

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