PDF(Pubmed)
Abstract：
OBJECTIVE: Pain is common in older individuals. In order to understand and treat pain in this group, reliable and valid measures are needed. This study aimed to evaluate: (1) the validity, utility, incorrect response rates and preference rates of 5 pain rating scales in older individuals; and (2) the associations between age, education level, and cognitive function and both (a) incorrect response and (b) preference rates.
METHODS: Two hundred and one orthopedic clinic outpatients ≥ 65 years old were asked to rate their current pain, and least, average, and worst pain intensity in the past week using 5 scales: Verbal Numerical Rating Scale (VNRS), Faces Pain Scale - Revised (FPS-R), Verbal Rating Scale (VRS), Numerical Rating Scale (NRS), and Visual Analogue Scale (VAS). Participants were also asked to indicate scale preference. We computed the associations between each measure and a factor score representing the shared variance among the scales, the incorrect response and scale preference rates, and the associations between incorrect response and preference rates and age, education level, and cognitive function. The incorrect responses included being unable to respond, providing more than one response, responses outside a range, providing range answers rather than fixed answers, and responses indicating \'least > average,\' \'least > worst,\' and \'average > worst\'.
RESULTS: The findings support validity of all 5 scales in older individuals who are able to use all measures. The VNRS had the lowest (2%) and the VAS had the highest (6%) incorrect response rates. The NRS was the most (35%) and the VAS was the least (5%) preferred. Age was associated with the incorrect response rates of the VRS and VAS, such that older individuals were less likely to use these scales correctly. Education level was associated with the incorrect response rates of the FPS-R, NRS and VAS, such that those with less education were less likely to use these measures correctly. Cognitive function was not significantly associated with incorrect response rates. Age, education level and cognitive function were not significantly associated with scale preference.
CONCLUSIONS: Although all five scales are valid, the VNRS evidences the best overall utility in this sample of older individuals with pain. The NRS or FPS-R would be fine alternatives if it is not practical or feasible to use the VNRS.
METHODS: Two hundred and one orthopedic clinic outpatients ≥ 65 years old were asked to rate their current pain, and least, average, and worst pain intensity in the past week using 5 scales: Verbal Numerical Rating Scale (VNRS), Faces Pain Scale - Revised (FPS-R), Verbal Rating Scale (VRS), Numerical Rating Scale (NRS), and Visual Analogue Scale (VAS). Participants were also asked to indicate scale preference. We computed the associations between each measure and a factor score representing the shared variance among the scales, the incorrect response and scale preference rates, and the associations between incorrect response and preference rates and age, education level, and cognitive function. The incorrect responses included being unable to respond, providing more than one response, responses outside a range, providing range answers rather than fixed answers, and responses indicating \'least > average,\' \'least > worst,\' and \'average > worst\'.
RESULTS: The findings support validity of all 5 scales in older individuals who are able to use all measures. The VNRS had the lowest (2%) and the VAS had the highest (6%) incorrect response rates. The NRS was the most (35%) and the VAS was the least (5%) preferred. Age was associated with the incorrect response rates of the VRS and VAS, such that older individuals were less likely to use these scales correctly. Education level was associated with the incorrect response rates of the FPS-R, NRS and VAS, such that those with less education were less likely to use these measures correctly. Cognitive function was not significantly associated with incorrect response rates. Age, education level and cognitive function were not significantly associated with scale preference.
CONCLUSIONS: Although all five scales are valid, the VNRS evidences the best overall utility in this sample of older individuals with pain. The NRS or FPS-R would be fine alternatives if it is not practical or feasible to use the VNRS.
摘要：
目的：疼痛在老年人中很常见。为了理解和治疗这个群体的疼痛，需要可靠和有效的措施。本研究旨在评估：(1)有效性，实用程序，老年人5种疼痛评分量表的不正确反应率和偏好率；(2)年龄、教育水平,和认知功能，以及(a)不正确的反应和(b)偏好率。
方法：要求200名65岁以上的骨科门诊患者对他们当前的疼痛进行评分，最少,平均,和最严重的疼痛强度在过去一周使用5个量表：言语数字评定量表（VNRS），面部疼痛量表-修订(FPS-R)言语评定量表（VRS），数值评级量表(NRS)，和视觉模拟量表(VAS)。参与者还被要求表明规模偏好。我们计算了每个度量与代表量表之间共享方差的因子得分之间的关联，不正确的反应和规模偏好率，以及不正确的反应与偏好率和年龄之间的关联，教育水平,和认知功能。不正确的响应包括无法响应，提供不止一个响应，范围之外的响应，提供范围答案而不是固定答案，和指示\'至少>平均值的响应，\'\'least>最差,\'和\'平均值>最差\'。
结果：这些发现支持所有5个量表在能够使用所有措施的老年人中的有效性。VNRS的不正确反应率最低（2％），VAS的不正确反应率最高（6％）。NRS最多(35%),VAS最少(5%)。年龄与VRS和VAS的不正确反应率相关，因此，老年人不太可能正确使用这些量表。教育水平与FPS-R的不正确反应率有关，NRS和VAS,因此，受教育程度较低的人不太可能正确使用这些措施。认知功能与不正确的反应率没有显着相关。年龄,教育水平和认知功能与量表偏好无显著相关。
结论：尽管所有五个量表都有效，VNRS表明，在这个有疼痛的老年个体样本中，总体效用最好。如果使用VNRS不实际或不可行，则NRS或FPS-R将是很好的替代方案。
方法：要求200名65岁以上的骨科门诊患者对他们当前的疼痛进行评分，最少,平均,和最严重的疼痛强度在过去一周使用5个量表：言语数字评定量表（VNRS），面部疼痛量表-修订(FPS-R)言语评定量表（VRS），数值评级量表(NRS)，和视觉模拟量表(VAS)。参与者还被要求表明规模偏好。我们计算了每个度量与代表量表之间共享方差的因子得分之间的关联，不正确的反应和规模偏好率，以及不正确的反应与偏好率和年龄之间的关联，教育水平,和认知功能。不正确的响应包括无法响应，提供不止一个响应，范围之外的响应，提供范围答案而不是固定答案，和指示\'至少>平均值的响应，\'\'least>最差,\'和\'平均值>最差\'。
结果：这些发现支持所有5个量表在能够使用所有措施的老年人中的有效性。VNRS的不正确反应率最低（2％），VAS的不正确反应率最高（6％）。NRS最多(35%),VAS最少(5%)。年龄与VRS和VAS的不正确反应率相关，因此，老年人不太可能正确使用这些量表。教育水平与FPS-R的不正确反应率有关，NRS和VAS,因此，受教育程度较低的人不太可能正确使用这些措施。认知功能与不正确的反应率没有显着相关。年龄,教育水平和认知功能与量表偏好无显著相关。
结论：尽管所有五个量表都有效，VNRS表明，在这个有疼痛的老年个体样本中，总体效用最好。如果使用VNRS不实际或不可行，则NRS或FPS-R将是很好的替代方案。
