The Functional Pain Scale: reliability, validity, and responsiveness in an elderly population.
The Functional Pain Scale: reliability, validity, and responsiveness in an elderly population.
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DOI：
10.1016/s1525-8610(04)70176-0
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发表时间：
2001-05-01
影响因子：
7.6
通讯作者：
Prosser, J
中科院分区：
文献类型：
--
作者：
Gloth, F M 3rd;Scheve, A A;Prosser, J
目的：由于在评估年老体弱患者的疼痛方面遇到困难，并且缺乏标准化的疼痛评估工具，因此开发并评估了功能性疼痛量表（FPS），一种结合主观和客观成分来评估疼痛的工具。100名65岁以上的受试者参加了功能性疼痛量表的有效性、可靠性和反应性（仪器对变化的临床敏感性）测试。受试者从老年病住院设置，老年病门诊设置，和当地的临终关怀（住在他们的家）。94名受试者完成了所有阶段的测试。信度进行了测试，采用重测格式和相关矩阵。与视觉模拟量表（VAS）、当前疼痛强度（PPI）、麦吉尔简表问卷（MPQ-SF）和数字疼痛量表（NXP）工具进行比较，建立了标准相关效度。FPS、VAS、PPI、MPQ-SF和VAS工具的反应性使用五种先前描述的技术确定：效应量、标准化反应平均值、相对效率、t检验评分的直接比较和P值的直接比较。制定了一个累积指数，对每个量表进行排名。累积反应性指数评分基于每个单独反应性测试的个体量表表现。累积反应性指数的最低分表示最反应scale.Results：评价者间的信度测试仪器超过0.95的所有仪器测试。有效性检验也显示出高度相关性（VAS、PPI、MPQ-SF和BMI分别为r = 0.62、r = 0.85、r = 0.80、r = 0.90）。通过反应性指数评估的反应性总体上最好的是功能性疼痛量表（7），其次是视觉模拟量表（12）、当前疼痛强度（13）、麦吉尔疼痛量表简表（19）和数字疼痛问卷（24）。结论：功能性疼痛量表被确定为可靠、有效和反应性。功能性疼痛量表的反应性上级其他测试工具。功能性疼痛量表是评估老年人疼痛的可接受工具，可能比其他测试工具更能反映疼痛的变化。需要在其他人群中进行进一步的测试。
OBJECTIVES: Because of difficulty experienced in assessing pain in frail older patients and the lack of pain assessment tools with standardization in the elderly, the Functional Pain Scale (FPS), an instrument incorporating both subjective and objective components to assess pain, was developed and evaluated.DESIGN, SETTING, PARTICIPANTS, AND MEASURES: One hundred subjects more than 65 years old participated in the validity, reliability, and responsiveness (the clinical sensitivity of the instrument to change) testing of the Functional Pain Scale. Subjects were recruited from a geriatrics inpatient setting, a geriatrics outpatient setting, and a local hospice (residing in their homes). Ninety-four of the subjects completed all phases of testing. Reliability was tested using a test-retest format and a correlation matrix. Criterion-related validity was established as compared with the Visual Analog Scale (VAS), the Present Pain Intensity (PPI), the McGill Short Form Questionnaire (MPQ-SF), and the Numeric Pain Scale (NPS) instruments. Responsiveness for the FPS, the VAS, the PPI, the MPQ-SF, and the NPS instruments was determined using five previously described techniques: effect size, standardized response means, relative efficiency, direct comparison of t test scores, and direct comparison of P values. A cumulative index was developed to rank each scale. Cumulative responsiveness index scores were based on individual scale performance for each separate responsiveness test. The lowest score in the cumulative responsiveness index indicated the most responsive scale.RESULTS: Interrater reliability for instruments tested exceeded 0.95 for all instruments tested. Validity testing showed high correlations as well (r = 0.62, r = 0.85, r = 0.80, r = 0.90 for the VAS, the PPI, the MPQ-SF, and the NPS respectively). Responsiveness evaluated overall by the responsiveness index was best for the Functional Pain Scale (7) followed by the Visual Analog Scale (12), the Present Pain Intensity (13), the McGill Pain Questionnaire-Short Form (19), and the Numerical Pain Questionnaire (24).CONCLUSIONS: The Functional Pain Scale was determined to be reliable, valid, and responsive. The responsiveness of the Functional Pain Scale was superior to the other instruments tested. The Functional Pain Scale is an acceptable instrument for assessing pain in older adults and may reflect changes in pain better than other instruments tested. Further testing in other populations is warranted.