Pain intensity assessment in older adults - Use of experimental pain to compare psychometric properties and usability of selected pain scales with younger adults
Pain intensity assessment in older adults - Use of experimental pain to compare psychometric properties and usability of selected pain scales with younger adults
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DOI：
10.1097/00002508-200407000-00002
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发表时间：
2004-07-01
影响因子：
2.9
通讯作者：
Richardson, G
中科院分区：
文献类型：
--
作者：
Herr, KA;Spratt, K;Richardson, G
目的：确定：（1）5种常用疼痛评定量表在年轻人和老年人中使用时的心理测量学特性和效用，（2）与未能成功使用疼痛评定量表相关的因素，（3）疼痛评定量表偏好，（4）影响量表偏好的因素。采用准实验设计，从86名年轻（25-55岁）和89名老年（65-94岁）成人志愿者样本中收集数据。采用垂直视觉模拟评分法（VAS）、21点数字评分法（NRS）、语言描述评分法（VDS）、11点语言数字评分法（VNS）和面孔疼痛评分法（FPS）测定受试者对热刺激的反应。而VDS最敏感、最可靠。除VAS外，疼痛量表完成的失败率极低。虽然年龄并不影响未能正确使用这种疼痛强度评定量表，但更常见的是与高龄相关的疾病，包括认知和心理障碍。在两组受试者中，最倾向于代表疼痛强度的量表是NRS，其次是VDS，量表偏好与认知状态、教育水平、年龄、种族或性别无关。虽然所有5个疼痛强度评定量表在任何一个年龄组使用时都是心理测量学上合理的，但失败，内部一致性信度，结构效度，量表敏感性，和偏好表明，VDS是评估老年人疼痛强度的首选量表，包括轻度至中度认知障碍的患者。
Objectives: To determine: (1) the psychometric properties and utility of 5 types of commonly used pain rating scales when used with younger and older adults, (2) factors related to failure to successfully use a pain rating scale, (3) pain rating scale preference, and (4) factors impacting scale preference.Methods: A quasi-experimental design was used to gather data from a sample of 86 younger (age 25-55) and 89 older (age 65-94) adult volunteer subjects. Responses of subjects to experimentally induced thermal stimuli were measured with the following pain intensity rating scales: vertical visual analog scale (VAS), 21-point Numeric Rating Scale (NRS), Verbal Descriptor Scale (VDS), I I-point Verbal Numeric Rating Scale (VNS), and Faces Pain Scale (FPS).Results: All 5 pain scales were effective in discriminating different levels of pain sensation; however the VDS was most sensitive and reliable. Failure rates for pain scale completion were minimal, except for the VAS. Although age did not impact failure to properly use this pain intensity rating scale, but rather those conditions more commonly associated with advanced age, including cognitive and psychemotor impairment did. The scale most preferred to represent pain intensity in both cohorts of subjects was the NRS, followed by the VDS, Scale preference was not related to cognitive status, educational level, age, race, or sex.Conclusion: Although all 5 of the pain intensity rating scales were psychometrically sound when used with either age group, failures, internal consistency reliability, construct validity, scale sensitivity, and preference suggest that the VDS is the scale of choice for assessing pain intensity among older adults, including those with mild to moderate cognitive impairment.