Pain scale

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A pain scale measures a patient's pain intensity or other features. Pain scales are based on self-report, observational (behavioral), or physiological data. Self-report is considered primary and should be obtained if possible. Pain scales are available for neonates, infants, children, adolescents, adults, seniors, and persons whose communication is impaired. Pain assessments are often regarded as "the 5th Vital Sign." [1]

Examples of pain scales
Self-report Observational Physiological
Infant Premature Infant Pain Profile; Neonatal/Infant Pain Scale
Child Faces Pain Scale - Revised;[2] Wong-Baker FACES Pain Rating Scale; Coloured Analogue Scale[3] FLACC (Face Legs Arms Cry Consolability Scale); CHEOPS (Children's Hospital of Eastern Ontario Pain Scale)[4] Comfort
Adult Visual Analog Scale (VAS); Verbal Numerical Rating Scale (VNRS); Verbal Descriptor Scale (VDS); Brief Pain Inventory

Partial list of pain measurement scales[edit]

  • Alder Hey Triage Pain Score [5]
  • Behavioral Pain Scale (BPS)[6]
  • Original index (1987)[20]
  • 1991 revision[21]
  • 1997 revision[22]

Specialized tests[edit]

  • Disease-Specific Pain Scale: DSPI = (ΣX · Y) · 100 where X is the highest pain level on a 0–10 scale and Y is the percentage of this pain level in the group. The DSPI is different from the simple numeric 0–10 scale in that it is measured for a group of patients with a specific diagnosis whereas the numeric 0–10 pain scale is administered individually.[32]
  • Pediatric Pain Questionnaire (PPQ)[33] for measuring pain in children
  • Premature Infant Pain Profile (PIPP)[34] for measuring pain in premature infants
  • Schmidt Sting Pain Index[35] and Starr sting pain scale[36] both for insect stings
  • Colorado Behavioral Numerical Pain Scale (for sedated patients)[37]
  • AUSCAN: Disease-Specific, to assess hand osteoarthritis outcomes.[19]
  • WOMAC : Disease-Specific, to assess knee osteoarthritis outcomes.[19]
  • Osteoarthritis Research Society International-Outcome Measures in Rheumatoid Arthritis Clinical Trials (OARSI-OMERACT) Initiative, New OA Pain Measure: Disease-Specific, Osteoarthritis Pain[19]

Numeric Rating Scale[edit]

The Numeric Rating Scale (NRS-11) is an 11–point scale for patient self-reporting of pain. It is for adults and children 10 years old or older.[38]

Rating Pain Level
0 No Pain
1 – 3 Mild Pain (nagging, annoying, interfering little with ADLs)
4 – 6 Moderate Pain (interferes significantly with ADLs)
7 – 10 Severe Pain (disabling; unable to perform ADLs)

See also[edit]

Notes[edit]

  1. ^ "Pain: current understanding of assessment, management and treatments.". Joint Commission on Accreditation of Healthcare Organizations and the National Pharmaceutical Council, Inc. December 2001. Retrieved January 2013. 
  2. ^ "The Faces Pain Scale – Revised". Pediatric Pain Sourcebook of Protocols, Policies and Pamphlets. 7 August 2007. 
  3. ^ Stinson, JN; Kavanagh, T; Yamada, J; Gill, N; Stevens, B (November 2006). "Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents". Pain 125 (1–2): 143–57. doi:10.1016/j.pain.2006.05.006. PMID 16777328. 
  4. ^ von Baeyer, C.L.; Spagrud, L.J. (2007). "Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years". Pain 127 (1–2): 140–150. doi:10.1016/j.pain.2006.08.014. PMID 16996689. 
  5. ^ Stewart B, Lancaster G, Lawson J, Williams K, Daly J (July 2004). "Validation of the Alder Hey Triage Pain Score". Arch. Dis. Child. 89 (7): 625–630. doi:10.1136/adc.2003.032599. PMC 1720010. PMID 15210492. 
  6. ^ Payen, JF; Bru O; Bosson JL (2001). "Assessing pain in critically ill sedated patients by using a behavioral pain scale". Critical Care Medicine 29: 2258–2263. doi:10.1097/00003246-200112000-00004. 
  7. ^ Cleeland CS, Ryan KM (March 1994). "Pain assessment: global use of the Brief Pain Inventory". Ann. Acad. Med. Singap. 23 (2): 129–38. PMID 8080219. 
  8. ^ Feldt, KS (2000). "The Checklist of Nonverbal Pain Indicators (CNPI)". Pain Manag Nurs. 1: 13–21. 
  9. ^ Gélinas, C; Fillion L; Puntillo KA; Viens C; Fortier M (2006). "Validation of the Critical-Care Pain Observation Tool in adult patients". American Journal of Critical Care 15 (4): 420–427. 
  10. ^ Ambuel, B; Hamlett KW; Marx CM; Blumer JL (1992). "Assessing distress in pediatric intensive care environments: the COMFORT scale". Journal of Pediatric Psychology 17 (1): 95–109. doi:10.1093/jpepsy/17.1.95. 
  11. ^ "Dallas Pain Questionnaire" (PDF). OARSI. Retrieved 1 March 2010. 
  12. ^ Ozguler A, Guéguen A, Leclerc A, Landre MF, Piciotti M, Le Gall S, Morel-Fatio M, Boureau F. (2002). "Using the dallas pain questionnaire to classify individuals with low back pain in a working population". Spine 27 (16): 1783–9. doi:10.1097/00007632-200208150-00018. PMID 12195072. 
  13. ^ Gracely RH, Kwilosz DM (December 1988). "The Descriptor Differential Scale: applying psychophysical principles to clinical pain assessment". Pain 35 (3): 279–88. doi:10.1016/0304-3959(88)90138-8. PMID 3226757. 
  14. ^ Hardy, J.D.; Wolff, H.G.; Goodell, H. (1952). Pain Sensations and Reactions. Baltimore: The Williams & Wilkins Co. ASIN B0006ASZ92. 
  15. ^ Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K (1991). "The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients". J Palliat Care 7 (2): 6–9. PMID 1714502. 
  16. ^ Nekolaichuk C, Watanabe S, Beaumont C (March 2008). "The Edmonton Symptom Assessment System: a 15-year retrospective review of validation studies (1991--2006)". Palliat Med 22 (2): 111–22. doi:10.1177/0269216307087659. PMID 18372376. 
  17. ^ Richardson LA, Jones GW (January 2009). "A review of the reliability and validity of the Edmonton Symptom Assessment System". Curr Oncol 16 (1): 55. doi:10.3747/co.v16i1.261. PMC 2644623. PMID 19229371. 
  18. ^ Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B (August 2001). "The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement". Pain 93 (2): 173–83. doi:10.1016/S0304-3959(01)00314-1. PMID 11427329. Retrieved 2008-05-26. Instructions in many languages and images
  19. ^ a b c d e "OARSI Initiatives, Pain Indexes". OARSI. Retrieved 1 March 2010. 
  20. ^ Lequesne M, Mery C, et al (1987). "Indexes of severity for osteoarthritis of the hip and knee". Scand J Rheumatology (Supplement 65): 85–89. 
  21. ^ Lequesne M (1991). "Indices of severity and disease activity for osteoarthritis". Seminars in Arthritis and Rheumatism 20 (Supplement 2): 48–54. doi:10.1016/0049-0172(91)90027-w. 
  22. ^ Lequesne MG (1997). "The algofunctional indices for hip and knee osteoarthritis". J Rheumatol 24: 779–781. 
  23. ^ Melzack R (September 1975). "The McGill Pain Questionnaire: major properties and scoring methods". Pain 1 (3): 277–99. doi:10.1016/0304-3959(75)90044-5. PMID 1235985. Retrieved 2008-05-26. 
  24. ^ Jensen MP, Karoly P, O'Riordan EF, Bland F, Burns RS (June 1989). "The subjective experience of acute pain. An assessment of the utility of 10 indices". Clin J Pain 5 (2): 153–9. doi:10.1097/00002508-198906000-00005. PMID 2520397. 
  25. ^ Hartrick CT, Kovan JP, Shapiro S (December 2003). "The numeric rating scale for clinical pain measurement: a ratio measure?". Pain Pract 3 (4): 310–6. doi:10.1111/j.1530-7085.2003.03034.x. PMID 17166126. 
  26. ^ Hearn J, Higginson IJ (December 1999). "Development and validation of a core outcome measure for palliative care: the palliative care outcome scale. Palliative Care Core Audit Project Advisory Group". Qual Health Care 8 (4): 219–27. doi:10.1136/qshc.8.4.219. PMC 2483665. PMID 10847883. 
  27. ^ Paul W Stratford, Jill M Binkley, Daniel L Riddle and Gordon H Guyatt (1998). "Sensitivity to Change of the Roland-Morris Back Pain Questionnaire: Part 1". Phys Ther 78 (11): 1186–1196. PMID 9806623. 
  28. ^ Schulte TL, Schubert T, Winter C, Brandes M, Hackenberg L, Wassmann H, Liem D, Rosenbaum D, Bullmann V. (2010). "Step activity monitoring in lumbar stenosis patients undergoing decompressive surgery". European spine journal (swetswise.com) 19 (11): 1855–64. doi:10.1007/s00586-010-1324-y. PMC 2989265. PMID 20186442. 
  29. ^ Higginson IJ, McCarthy M (1993). "Validity of the support team assessment schedule: do staffs' ratings reflect those made by patients or their families?". Palliat Med 7 (3): 219–28. doi:10.1177/026921639300700309. PMID 7505183. 
  30. ^ "Wong-Baker FACES Pain Rating Scale Foundation". Retrieved 6 December 2009. 
  31. ^ Huskisson EC (1982). "Measurement of pain". J. Rheumatol. 9 (5): 768–9. PMID 6184474. 
  32. ^ Walid MS, Zaytseva NV (2009). "Pain in Nursing Home Residents and Correlation with Neuropsychiatric Disorders". Pain Physician 12 (5): 877–880. ISSN 1533-3159. PMID 19787013. 
  33. ^ Varni JW, Thompson KL, Hanson V (January 1987). "The Varni/Thompson Pediatric Pain Questionnaire. I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis". Pain 28 (1): 27–38. doi:10.1016/0304-3959(87)91056-6. PMID 3822493. 
  34. ^ Ballantyne M, Stevens B, McAllister M, Dionne K, Jack A (December 1999). "Validation of the premature infant pain profile in the clinical setting". Clin J Pain 15 (4): 297–303. doi:10.1097/00002508-199912000-00006. PMID 10617258. Retrieved 2008-05-26. 
  35. ^ Schmidt, Justin O.; Evans, David (1990). Hymenopteran venoms: striving toward the ultimate defense against vertebrates; chapter in Insect defenses: adaptive mechanisms and strategies of prey and predators. Albany, N.Y: State University of New York Press. pp. 387–419. ISBN 0-88706-896-0. 
  36. ^ Starr, C.K. (1985). "A simple pain scale for field comparison of Hymenopteran stings". Journal of Entomological Science 20 (2): 225–231. 
  37. ^ Salmore R (2002). "Development of a new pain scale: Colorado Behavioral Numerical Pain Scale for sedated adult patients undergoing gastrointestinal procedures". Gastroenterol Nurs 25 (6): 257–62. doi:10.1097/00001610-200211000-00007. PMID 12488689. Retrieved 2008-05-26. 
  38. ^ "Pain Intensity Instruments". National Institutes of Health – Warren Grant Magnuson Clinical Center. July 2003. Archived from the original on 2012-09-14.