Latent variables may be useful in pain's assessment.

Background: Unobserved "latent" variables have the potential to minimize "measurement error" inherent to any single clinical assessment or categorical diagnosis.Objectives: To demonstrate the potential utility of latent variable constructs in pain's assessment.Design: We created two latent variables...

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Publicado en:Health & Quality of Life Outcomes Vol. 12; no. 1; pp. 13 - 14
Autores principales: Royall, Donald R, Salazar, Ricardo, Palmer, Raymond F
Formato: research Journal Article
Publicado: BioMed Central 2014
Acceso en línea:Ver este registro en EBSCOhost
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      pub: BioMed Central
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        atl: Latent variables may be useful in pain's assessment.
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          Royall, Donald R
          Salazar, Ricardo
          Palmer, Raymond F
        affil: Department of Psychiatry, The University of Texas Health Science Center At San Antonio, 7703 Floyd Curl Drive MC 7792, San Antonio, TX 78229, USA. royall@uthscsa.edu.
      sug:
        subj:
          Pain Measurement Methods
          Activities of Daily Living Psychosocial Factors
          Aged
          Aged, 80 and Over
          Depression Diagnosis
          Depression Psychosocial Factors
          Female
          Hispanic Americans Psychosocial Factors
          Hispanic Americans Statistics and Numerical Data
          Human
          Prospective Studies
          Male
          Pain Complications
          Pain Diagnosis
          Pain Psychosocial Factors
          Psychological Tests
          Sleep Disorders Epidemiology
          Sleep Disorders Etiology
          Southwestern United States
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Background: Unobserved "latent" variables have the potential to minimize "measurement error" inherent to any single clinical assessment or categorical diagnosis.Objectives: To demonstrate the potential utility of latent variable constructs in pain's assessment.Design: We created two latent variables representing depressive symptom-related pain (Pd) and its residual, "somatic" pain (Ps), from survey questions.Setting: The Hispanic Established Population for Epidemiological Studies in the Elderly (H-EPESE) project, a longitudinal population-based cohort study.Participants: Community dwelling elderly Mexican-Americans in five Southwestern U.S. states. The data were collected in the 7th HEPESE wave in 2010 (N = 1,078).Measurements: Self-reported pain, Center for Epidemiological Studies Depression Scale (CES-D) scores, bedside cognitive performance measures, and informant-rated measures of basic and instrumental Activities of Daily Living.Results: The model showed excellent fit [χ2 = 20.37, DF = 12; p = 0.06; Comparative fit index (CFI) = 0.998; Root mean statistical error assessment (RMSEA) = 0.025]. Ps was most strongly indicated by self-reported pain-related physician visits (r = 0.48, p ≤0.001). Pd was most strongly indicated by self-reported pain-related sleep disturbances (r = 0.65, p <0.001). Both Pd and Ps were significantly independently associated with chronic pain (> one month), regional pain and pain summed across selected regions. Pd alone was significantly independently associated with self-rated health, life satisfaction, self-reported falls, Life-space, nursing home placement, the use of opiates, and a variety of sleep related disturbances. Ps was associated with the use of NSAIDS. Neither construct was associated with declaration of a resuscitation preference, mode of resuscitation preference declaration, or with opting for a "Do Not Resuscitate" (DNR) order.Conclusion: This analysis illustrates the potential of latent variables to parse observed data into "unbiased" constructs with unique predictive profiles. The latent constructs, by definition, are devoid of measurement error that affects any subset of their indicators. Future studies could use such phenotypes as outcome measures in clinical pain management trials or associate them with potential biomarkers using powerful parametric statistical methods.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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