Pain scale
A pain scale measures a patient's pain intensity or other features. Pain scales are a common communication tool in medical contexts, and are used in a variety of medical settings. Pain scales are a necessity to assist with better assessment of pain and patient screening. Pain measurements help determine the severity, type, and duration of the pain, and are used to make an accurate diagnosis, determine a treatment plan, and evaluate the effectiveness of treatment.[medical citation needed] Pain scales are based on trust, cartoons (behavioral), or imaginary data, and 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]
A patient's self-reported pain is so critical in the pain assessment method that it has been described as the "most valid measure" of pain.[2][3] The focus on patient report of pain is an essential aspect of any pain scale, but there are additional features that should be included in a pain scale. In addition to focusing on the patient's perspective, a pain scale should also be free of bias, accurate and reliable, able to differentiate between pain and other undesired emotions, absolute not relative, and able to act as a predictor or screening tool.[2]
Self-report | Observational | Physiological | |
---|---|---|---|
Infant | — | Premature Infant Pain Profile; Neonatal/Infant Pain Scale | — |
Child | FLACC (Face Legs Arms Cry Consolability Scale); CHEOPS (Children's Hospital of Eastern Ontario Pain Scale)[6] | Comfort; Wharton PAIN Scale | |
Adult | Visual Analog Scale (VAS); Verbal Numerical Rating Scale (VNRS); Verbal Descriptor Scale (VDS); Brief Pain Inventory | Wharton Impairment and Pain Scale | Wharton PAIN Scale |
Partial list of pain measurement scales
- Alder Hey Triage Pain Score[7]
- Behavioral Pain Scale (BPS)[8]
- Brief Pain Inventory (BPI)[9]
- Checklist of Nonverbal Pain Indicators (CNPI)[10]
- Clinical Global Impression (CGI)[11]
- COMFORT scale[12]
- Color Scale for Pain[13]
- Critical-Care Pain Observation Tool (CPOT)[14]
- Dallas Pain Questionnaire[15][16]
- Descriptor differential scale (DDS)[17]
- Dolorimeter Pain Index (DPI)[18]
- Edmonton Symptom Assessment System[19][20][21]
- Face Legs Activity Cry Consolability scale
- Faces Pain Scale – Revised (FPS-R)[22]
- Global Pain Scale[23]
- Lequesne algofunctional index: a composite measure of pain and disability, with separate self-report questionnaires for hip and knee OA (osteoarthritis):[24]
- Mankoski Pain Scale[28]
- McGill Pain Questionnaire (MPQ)[29]
- Multiple Pain Rating Scales[30]
- Neck Pain and Disability Scale –NPAD[24]
- Numerical 11 point box (BS-11)[31]
- Numeric Rating Scale (NRS-11)[32]
- Oswestry Disability Index
- Palliative Care Outcome Scale (PCOS)[33]
- Roland-Morris Back Pain Questionnaire[34][35]
- Support Team Assessment Schedule (STAS)[36]
- Wharton Pain and Impairment Numeric Scale (Wharton PAIN Scale)[37]
- Wong-Baker FACES Pain Rating Scale[38]
- Visual analog scale (VAS)[39]
Specialized tests
- Abbey pain scale for people with end-stage dementia[40]
- AUSCAN: Disease-Specific, to assess hand osteoarthritis outcomes.[24]
- Colorado Behavioral Numerical Pain Scale (for sedated patients)[41]
- CPOT For those who can't self report[42]
- Osteoarthritis Research Society International-Outcome Measures in Rheumatoid Arthritis Clinical Trials (OARSI-OMERACT) Initiative, New OA Pain Measure: Disease-Specific, Osteoarthritis Pain[24]
- Oucher Scale for Pediatrics[43]
- Pain Assessment in Advanced Dementia (PAINAD)
- Pediatric Pain Questionnaire (PPQ)[44] for measuring pain in children
- Premature Infant Pain Profile (PIPP)premature infants
- both for insect stings
- WOMAC : Disease-Specific, to assess knee osteoarthritis outcomes.[24]
Numeric rating scale
The Numeric Rating Scale (NRS-11) is an 11-point scale for patient self-reporting of pain. It is based solely on the ability to perform activities of daily living (ADLs) and can be used for adults and children 10 years old or older.[48]
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) |
Pain interferes with a person's ability to perform ADLs. Pain also interferes with a person's ability to concentrate, and to think. A sufficiently strong pain can be disabling on a person's concentration and coherent thought, even though it is not strong enough to prevent that person's performance of ADLs. However, there is no system available for measuring concentration and thought.
In endometriosis
The most common pain scale for quantification of
See also
Notes
- ^ "Pain: current understanding of assessment, management and treatments" (PDF). Joint Commission on Accreditation of Healthcare Organizations and the National Pharmaceutical Council, Inc. December 2001. Retrieved 2018-01-20.
- ^ a b "Pain Assessment Tools". paincommunitycentre.org.
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- ^ "The Faces Pain Scale – Revised". Pediatric Pain Sourcebook of Protocols, Policies and Pamphlets. 7 August 2007.
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- ^ "Use color-coded scale to assess children's pain". www.reliasmedia.com. Retrieved 2019-03-20.
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- ^ "Dallas Pain Questionnaire" (PDF). Workforce Safety. Retrieved 21 May 2017.
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- ^ Doctor, Pain. "Global Pain Scale". Pain Doctor. Retrieved 2019-03-20.
- ^ OARSI. Retrieved 1 March 2010.
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- ^ "Pain Scale". members.upnaway.com. Retrieved 2019-03-20.
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- ^ "Multiple Pain Rating Scales - back, leg, neck, migraine". Retrieved 27 June 2017.
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- ^ "Wharton Impairment and Pain Scale". January 2023.
- ^ "Wong-Baker FACES Pain Rating Scale Foundation". Retrieved 6 December 2009.
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- ^ "Critical Care Pain Observation Tool (CPOT)". MDCalc. Retrieved 2019-03-20.
- ^ "How to use the Oucher". www.oucher.org. Retrieved 2019-03-20.
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- ^ "Pain Intensity Instruments" (PDF). National Institutes of Health – Warren Grant Magnuson Clinical Center. July 2003. Archived from the original (PDF) on 2011-12-15.