Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department
Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department
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DOI：
10.1197/aemj.10.4.390
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发表时间：
2003-04-01
影响因子：
4.4
通讯作者：
Gallagher, EJ
中科院分区：
文献类型：
--
作者：
Bijur, PE;Latimer, CT;Gallagher, EJ
目标：从 0 到 10 的口头数字评定量表 (NRS) 通常用于测量疼痛，但尚未在急诊科 (ED) 环境中得到验证。作者希望评估 NRS 和视觉模拟量表 (VAS) 作为急性疼痛测量的可比性，并确定 NRS 上可检测到的最小临床显着疼痛差异。方法：这是一项前瞻性队列研究，研究对象为因急性疼痛而到城市急诊科就诊的成年人。患者口头评价疼痛强度为 0 到 10 之间的整数（0 = 无疼痛，10 = 最严重的疼痛），并标记以这些描述符为界的 10 厘米水平 VAS。 VAS 和 NRS 数据在就诊时、30 分钟后和 60 分钟后获得。在 30 分钟和 60 分钟时，患者被问及他们的疼痛是否“少得多”、“少了一点”、“大致相同”、“多了一点”还是“多了很多”。针对五类疼痛描述符中的每一类，计算以 30 分钟间隔获得的 VAS 和 NRS 连续测量值之间的差异。 VAS 和 NRS 评分之间的关联表示为相关系数。 VAS 分数根据 NRS 分数进行回归，以评估措施的等效性。与描述符“少一点”或“多一点”相关的平均变化被组合起来，以定义在 VAS 和 NRS 上测量的疼痛的最小临床显着差异。结果：在 108 名患者中，103 名患者在 30 分钟时提供数据，86 名患者在 60 分钟时提供数据。 NRS 评分与所有时间段的 VAS 评分均密切相关（r = 0.94，95% CI = 0.93 至 0.95）。回归线的斜率为 1.01（95% CI = 0.97 至 1.06），y 截距为 -0.34（95% CI = -0.67 至 -0.01）。 NRS 上疼痛的最小临床显着差异为 1.3（95% CI = 1.0 至 1.5），VAS 上的最小临床显着差异为 1.4（95% CI = 1.1 至 1.7）。结论：研究结果表明，在急性疼痛测量中，口头 NRS 可以替代 VAS。
objectives: Verbally administered numerical rating scales (NRSs) from 0 to 10 are often used to measure pain, but they have not been validated in the emergency department (ED) setting. The authors wished to assess the comparability of the NRS and visual analog scale (VAS) as measures of acute pain, and to identify the minimum clinically significant difference in pain that could be detected on the NRS. Methods: This was a prospective cohort study of a convenience sample of adults presenting with acute pain to an urban ED. Patients verbally rated pain intensity as an integer from 0 to 10 (0 = no pain, 10 = worst possible pain), and marked a 10-cm horizontal VAS bounded by these descriptors. VAS and NRS data were obtained at presentation, 30 minutes later, and 60 minutes later. At 30 and 60 minutes, patients were asked whether their pain was "much less," "a little less," "about the same," "a little more," or "much more." Differences between consecutive pairs of measurements on the VAS and NRS obtained at 30-minute intervals were calculated for each of the five categories of pain descriptor. The association between VAS and NRS scores was expressed as a correlation coefficient. The VAS scores were regressed on the NRS scores in order to assess the equivalence of the measures. The mean changes associated with descriptors "a little less" or "a little more" were combined to define the minimum clinically significant difference in pain measured on the VAS and NRS. Results: Of 108 patients entered, 103 provided data at 30 minutes and 86 at 60 minutes. NRS scores were strongly correlated to VAS scores at all time periods (r = 0.94,95% CI = 0.93 to 0.95). The slope of the regression line was 1.01 (95% CI = 0.97 to 1.06) and the y-intercept was -0.34 (95% CI = -0.67 to -0.01). The minimum clinically significant difference in pain was 1.3 (95% CI = 1.0 to 1.5) on the.NRS and 1.4 (95% CI = 1.1 to 1.7) on the VAS. Conclusions: The findings suggest that the verbally administered NRS can be substituted for the VAS in acute pain measurement.