[Validation of the German-language version of the Injustice Experience Questionnaire (IEQ) in five outpatient clinics]. / Validierung der deutschen Übersetzung des Injustice Experience Questionnaire (IEQ) in 5 ambulanten Schmerzbehandlungseinrichtungen.

INTRODUCTION: Occupational and social rehabilitation can be influenced by perceived injustice that results from pain. Currently, the Injustice Experience Questionnaire (IEQ), the tool most commonly used to assess perceived injustice, is not available in German. The aim of this study was the validation of the German-language version of the IEQ. MATERIALS AND METHODS: The validation of the IEQ was carried out via a web-based survey. For this purpose, participants completed the IEQ and construct-related scales analogous to the original study Tampa Scale of Kinesiophobia (TSK), Depression scale of the Depression Anxiety and Stress Scales (D-DASS), Pain Disability Index (PDI), and McGill Pain Questionnaire (MPQ). In addition, the participants completed questions on their socioeconomic status and on the cause of their pain, taken from the German Pain Questionnaire. RESULTS: Of 223 respondents, 134 (60.1%) returned a completed questionnaire and were included in the study. In all, 26.1% of participants reported suffering from pain resulting from accidents. None of the reviewed one- to three-factor solutions for the IEQ's structure achieved a good model fit. The best results were found for a two-factor solution, whereby the exploratory factor analysis revealed almost all items loaded highly on both factors and the confirmatory factor analysis showed high correlations between the factors. These findings are consistent with previous studies. The IEQ correlated highly and significantly with the other psychological instruments. There were no floor or ceiling effects. Cronbach's α for the German IEQ version was 0.93 and thus attests a high level of internal consistency. CONCLUSION: The analyses attest the excellent psychometric properties of the German translation of the IEQ and so the German-language version of the IEQ can be used as a validated questionnaire to screen for perceived injustice.

[German transcultural translation of the Injustice Experience Questionnaire]. / Deutsche transkulturelle Übersetzung des Injustice Experience Questionnaire.

BACKGROUND: Occupational and social rehabilitation is influenced by perceived injustice as a result of injury. To assess perceived injustice, the Injustice Experience Questionnaire (IEQ) has been developed and is available in English. The aim of this study was to translate and culturally adapt the English version of the IEQ into German. MATERIALS AND METHODS: The IEQ was translated into German according to the criteria for the transcultural adaptation of self-assessment tools. The translation was examined in a sample of 19 pain patients as to whether the translated items were comprehensible, unacceptable or offensive, and what their meaning and the reason for the chosen response were. Data were assessed using nonparametric statistical methods. RESULTS: The German translation of the IEQ showed a high degree of comprehensibility. The items' meanings and participants' selected answer options were rated as highly plausible by two raters and the wording of the items was assessed as being neither unacceptable nor offensive by participants. Because of the slightly increased values with regard to Item 3, whose meaning was unrecognized by the raters, the term "Unachtsamkeit" was replaced by "Unaufmerksamkeit." CONCLUSION: The study attests to the cultural and linguistic intelligibility and precision of the German translation of the IEQ. In a follow-up study, the translation should be validated in a larger sample of pain patients.

[Pain in patients with paraplegia]. / Schmerzen bei Patienten mit Querschnittlähmung.

Chronic pain is one of the most reported health problems in patients suffering from spinal cord injuries and is described by the patients as one of the most burdensome sequelae of paraplegia. Various types of pain, such as nociceptive, neuropathic and other types of pain can occur. In addition, multiple pathophysiological mechanisms based on the biopsychosocial pain model play a role in the origins of the pain. These aspects necessitate a multimodal pain management approach in this patient group. This article presents an overview of the occurrence, importance and pathophysiology of chronic pain following spinal cord injury as well as diagnostic and therapeutic approaches.

[Outpatient multimodal pain therapy : Results of a 1-week intensive outpatient multimodal group program for patients with chronic unspecific back pain - retrospective evaluation after 3 and 12 months]. / Ambulante multimodale Schmerztherapie : Ergebnisse eines 1­wöchigen ambulanten intensiven multimodalen Gruppenprogramms für Patienten mit chronischen unspezifischen Rückenschmerzen ­ retrospektive Evaluation nach 3 und 12 Monaten.

BACKGROUND: Interdisciplinary pain therapy is nowadays the state of the art for the treatment of chronic unspecific back pain. The aim of this article is to present the retrospective analysis of the data from a 1-week intensive outpatient multimodal interdisciplinary pain therapy group program for treatment of patients with chronic unspecific back pain. DESIGN AND METHODS: The questionnaire-based data from patients who attended the program were evaluated before as well as 3 and 12 months after finishing the program. The patients were questioned regarding parameters, such as pain severity, quality of life, pain-related disability, depression and pain acceptance. RESULTS: On average a significant improvement of all parameters after 3 and 12 months could be demonstrated (excluding the domains "social" and "environment" in the context of quality of life). DISCUSSION: Interestingly, the results showed a significant improvement of almost all evaluated parameters even after a period of 12 months (unfortunately only data for 41 patients were available). In our opinion this improvement is due to the special constellation of the presented program, which with 1 week is relatively short but very intensive with 34 h of treatment. In addition, the program is integrated into a long-term multimodal outpatient treatment, a concept in which the multimodal treatment is individually continued after the 1­week program. On the other hand, the results especially after 12 months have to be interpreted particularly in this context.

[Implementation of an electronic patient record. Experience in an interdisciplinary pain clinic]. / Implementierung einer elektronischen Krankenakte. Erfahrungen in einer interdisziplinären Schmerzklinik.

A complex electronic patient record was implemented in an interdisciplinary pain clinic. The goal was to create a tool that would allow structured access to the entries made by all specialty groups and permit data analysis for statistical and scientific purposes by means of integrated, coded fields. An electronic workflow was developed to facilitate the processing of documents. All entries dictated were converted to digital form and recorded directly into the electronic chart. Additional features included a structured medication list and a connection to the hospital's pre-existing electronic records. The various elements to be included in the chart were determined by an interdisciplinary team and progressively implemented using a commercially available system as a basis. In conclusion, implementation of a complex electronic patient record provides a valuable instrument for quality control, interdisciplinary collaboration and improved efficiency in a large, multimodal pain clinic.

[Peripheral pain syndrome]. / Periphere Schmerzsyndrome.

The bases for peripheral pain syndromes of the musculoskeletal system, which are common and often difficult to treat, involve complex neurophysiologic changes. They are generally very troublesome for the patient and result in long-term disability and absence from work and sport activities. As all levels of the pain perception system are involved, evaluation has to take place at the peripheral, spinal and central nervous system levels. Treatment requires a concept including all affected structures. If this is not the case, an inefficient series of monotherapies often results, which increases the risk of pain chronification in these patients similar to the situation found for low back pain. The biomechanical-functional aspect is of great importance for the lower extremities. This point of view, which is familiar to the orthopedist, reveals a clear connection between pain and disturbed function, permitting a clear concept for a successful therapy.

[How can I assess the back pain status in my patients? The Mainz chronic disease staging method and its prognostic value]. / Wie schätze ich die Rückenschmerzsituation meines Patienten ein? Die Mainzer Chronifizierungsstadien und ihre prognostische Bedeutung.

Chronification of pain is not just a simple matter of duration, although many publications still pretend that this is so. Chronification is more a spread of pain on the physical level, on duration and even more on the psychological and social levels. We present different models to explain this process. Instruments to evaluate the amount of chronification are presented in comparison, on the one hand the graduation of chronic pain by von Korff, on the other hand the Mainz pain staging system (MPSS). Results of different inquiries have shown the correlation between chronicity of pain and measurements of quality of life and effectiveness of medical treatment. Also the MPSS has a prognostic value about the effect of further treatment. To get a differentiated view on the results of examinations and treatment outcome, an evaluation of the chronification process of the patient's pain is a necessity.