Page 46 - Demo

Chapter 344local injection?), which was answered as yes or no. Patients who answered “yes” were directed to answer three subsequent questions using a 5-point NRS. These three questions asked about how well the previous injection had worked for the patient (0, did not work at all; 5, worked well), the intensity of pain that the patient had felt during their prior injection (0 no pain at all; 5, extremely painful), and how the patient had felt about the previous injections (0, very relaxed; 5, extremely anxious). The last question of the second part of the questionnaire was used to obtain information about anxiety regarding future injections was also answered using a 5-point NRS, with 0 indicating very relaxed and 5 indicating extremely anxious. The third and final part of the questionnaire was completed after the injection, and was focused on evaluating the patient’s experience after the injection. It comprised two questions about the pain and anxiety experience during the injection, which were answered using an 11-point NRS.To obtain additional measurements of the pain and anxiety experienced during the injections, each patient was connected to two finger cuff-based sensors: a blood volume pulse (BVP) sensor and a sweat conductance or galvanic skin response (SC/GSR) sensor. The BVP sensor was connected to the index finger of the left hand, and measured heart rate (HR) and relative blood flow (rBF) based on arterial expansion in the finger, with a registration range of 40-240 beats/minute. This sensor can detect a nociceptive response starting before and during the injection procedure, which can be interpreted a measurement of pain and anxiety. The SC/GSR sensor was attached to both the middle finger and the ring finger of the left hand. This sensor uses two electrodes that both measure relative changes in skin conductance, relaying information regarding sweat gland activity. The registration range of the SC/GSR sensor is 0.1-1000 microsiemens. These sensors were coupled to the NeXus-10, a multi-channel real-time physiological monitoring and biofeedback system (Mind Media BV, Herten, The Netherlands). The sensors’ signals were recorded online in realtime using the Biotrace+ software (Mind Media BV) on a computer connected through a wireless Bluetooth interface. The Biotrace+ software registered physiological measurements before and during the injections.