A comparison of pain rating scales

doi:10.1016/0022-3999(80)90032-X

Journal of Psychosomatic Research

Volume 24, Issues 3–4, 1980, Pages 119-124

https://doi.org/10.1016/0022-3999(80)90032-X Get rights and content

Abstract

In the course of studying episiotomy pain in a small group of women (n = 26), a number of commonly used rating scales were compared. The results showed wide variation in the distribution of ratings between scales. Variation also emerged with respect to the degree of concordance between rating scale differences over time and subjective comparisons. The implications of these results are considered in terms of: (a) the way in which reliance on single rating scales may give rise to a misleading impression; and (b) the need to assess the various components of pain. Routine inclusion of multidimensional assessment methods is recommended.

References (17)

E.C. Huskisson
Measurement of pain
Lancet
(1974)
J.E. Johnson et al.
Sensory and distress components of pain
Nurs. Res.
(1974)
R. Melzack
The McGill Pain Questionnaire: Major properties and scoring methods
Pain
(1975)
J. Scott et al.
Graphic representation of pain
Pain
(1976)
E.E. Ohnhaus et al.
Methodological problems in the measurement of pain: a comparison between the verbal rating scale and the visual analogue scale
Pain
(1975)
R.E.A. Peck
A precise technique for the measurement of pain
Headache
(1967)
R.H. Graceley et al.
Ratio scales of sensory end affective verbal pain descriptors
Pain
(1978)
A.E. Reading et al.
A card sort method of pain assessment
J. Psychosom. Res.
(1979)

There are more references available in the full text version of this article.

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The VRS is used chiefly in patients who are unable to use a VAS or NRS (due to poor comprehension or difficulty with abstract concepts). Metrology: the results of the VAS, NRS, and VRS show correlations ranging from 0.70 to 0.75 [18,19]. However, the correlations are not linear and the three scales are not interchangeable.
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La rhumatologie est une spécialité où l’on est confronté aux symptômes des patients, au premier rang desquels figure la douleur. Il existe plusieurs scores validés pour évaluer la douleur. Les échelles unidimensionnelles de la douleur, telles que l’échelle visuelle analogique ou l’échelle numérique simple sont rapides à réaliser mais présentent certaines limitations importantes à connaître. Certaines situations cliniques nécessitent l’emploi de questionnaires multidimensionnels, telles que le Questionnaire Saint-Antoine ou l’inventaire multidimensionnel de la douleur par exemple. L’ensemble des composantes de la douleur peut ainsi être évalué et prise en charge. Dans cet article, nous verrons les principaux critères rapportés par le patient permettant d’évaluer la douleur, et les propriétés psychométriques de ces questionnaires. Nous discuterons aussi du choix d’un questionnaire pour évaluer la douleur selon le cadre (pratique quotidienne, recherche).
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These complications can be potentially devastating for mothers and may affect relationships with their partner and bonding with the newborn child. Several pain scores have previously been used to assess perineal pain [3–14]. However, no study has used a validated pain score to assess perineal pain following vaginal birth complicated by obstetric anal sphincter injuries (OASIS).
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A comparison of pain rating scales

Abstract

Lancet

Nurs. Res.

Pain

Pain

Pain

A precise technique for the measurement of pain

Headache

Ratio scales of sensory end affective verbal pain descriptors

Pain

A card sort method of pain assessment

J. Psychosom. Res.