scholarly journals Reliability and Validity of the Global Pain Scale with Chronic Pain Sufferers

2011 ◽  
Vol 1;14 (1;1) ◽  
pp. 61-70
Author(s):  
Douglas Gentile
Keyword(s):  
Chronic Pain ◽  
Construct Validity ◽  
Pain Assessment ◽  
Short Form ◽  
Pain Scale ◽  
Survey Study ◽  
Affective Factors ◽  
Body Regions ◽  
Pain Scales ◽  
Global Pain

Background: Many pain scales exist today; however, a comprehensive, easy-to-analyze test has yet to be available to evaluate a patient’s pain and understand the sociocultural, cognitive, and affective factors contributing to a patient’s overall pain experience. Many scales have attempted to create an all-encompassing pain assessment but remain incomplete in their assessment of pain and the contributing aspects of pain. Objective: To present the Global Pain Scale (GPS) as an alternative to current pain assessments and evaluate the reliability and construct validity of the GPS. Methods: Two hundred sixty-two undergraduates with chronic pain at a large midwestern university participated in this survey study. Participants reported in which of 14 specific body regions they have pain, the frequency of pain, and treatment history for their pain. Participants completed 4 scales— GPS, the West Haven Yale Scale (WHY), the Perceived Stress Scale (PSS), and the short form McGill (SF-MPQ) — in a randomized order. Results: The GPS demonstrated high criterion validity and high construct validity (including both convergent and discriminant validity). The total GPS scale and each of the subscales were reliable. The total GPS score was significantly correlated with all other subscales, excluding those for which there is a theoretical reason for them to not be correlated with our participant population. Limitations: A sample of college students was used, thus decreasing the generalizability of these findings to patients approximating our sample. Conclusions: The GPS is a valid scale that is concise and easily interpreted. The GPS is a comprehensive assessment of pain evaluating pain, emotions, clinical outcomes, and daily activities. This may be a valuable tool for evaluation and treatment planning for interventional pain management physicians. Key words: chronic pain, pain assessment comprehensive pain scale, pain scales

scholarly journals An Objective Pain Score for Chronic Pain Clinic Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Agnes K. Pace ◽  
Melanio Bruceta ◽  
John Donovan ◽  
Sonia J. Vaida ◽  
Jill M. Eckert
Keyword(s):  
Chronic Pain ◽  
Construct Validity ◽  
Concurrent Validity ◽  
Interrater Reliability ◽  
Pain Scale ◽  
Pain Clinic ◽  
Positive Correlation ◽  
Pain Scales ◽  
Chronic Pain Patients ◽  
Pain Patients

Objectives. Although numerous studies have looked at the numeric rating scale (NRS) in chronic pain patients and several studies have evaluated objective pain scales, no known studies have assessed an objective pain scale for use in the evaluation of adult chronic pain patients in the outpatient setting. Subjective scales require patients to convert a subjective feeling into a quantitative number. Meanwhile, objective pain scales utilize, for the most part, the patient’s behavioral component as observed by the provider in addition to the patient’s subjective perception of pain. This study aims to examine the reliability and validity of an objective Chronic Pain Behavioral Pain Scale for Adults (CBPS) as compared to the traditional NRS. Methods. In this cross-sectional study, patients were assessed before and after an interventional pain procedure by a researcher and a nurse using the CBPS and the NRS. Interrater reliability, concurrent validity, and construct validity were analyzed. Results. Interrater reliability revealed a fair-good agreement between the nurse’s and researcher’s CBPS scores, weighted kappa values of 0.59 and 0.65, preprocedure and postprocedure, respectively. Concurrent validity showed low positive correlation for the preprocedure measurements, 0.34 (95% CI 0.16–0.50) and 0.47 (95% CI 0.31–0.61), and moderate positive correlation for the postprocedure measurements, 0.68 (95% CI 0.56–0.77) and 0.67 (95% CI 0.55–0.77), for the nurses and researchers, respectively. Construct validity demonstrated an equally average significant reduction in pain from preprocedure to postprocedure, CBPS and NRS median (IQR) scores preprocedure (4 (2–6) and 6 (4–8)) and postprocedure (1 (0–2) and 3 (0–5)), p < 0.001 . Discussion. The CBPS has been shown to have interrater reliability, concurrent validity, and construct validity. However, further testing is needed to show its potential benefits over other pain scales and its effectiveness in treating patients with chronic pain over a long-term. This study was registered with ClinicalTrial.gov with National Clinical Trial Number NCT02882971.

scholarly journals Monitoring Acute Pain in Donkeys with the Equine Utrecht University Scale for Donkeys Composite Pain Assessment (EQUUS-DONKEY-COMPASS) and the Equine Utrecht University Scale for Donkey Facial Assessment of Pain (EQUUS-DONKEY-FAP)

Animals ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 354 ◽  
Author(s):  
Machteld C. van Dierendonck ◽  
Faith A. Burden ◽  
Karen Rickards ◽  
Johannes P.A.M. van Loon
Keyword(s):  
Postoperative Pain ◽  
Acute Pain ◽  
Pain Assessment ◽  
Pain Scale ◽  
Follow Up Study ◽  
Observer Reliability ◽  
Pain Scales ◽  
Different Types ◽  
Good For

Objective pain assessment in donkeys is of vital importance for improving welfare in a species that is considered stoic. This study presents the construction and testing of two pain scales, the Equine Utrecht University Scale for Donkey Composite Pain Assessment (EQUUS-DONKEY-COMPASS) and the Equine Utrecht University Scale for Donkey Facial Assessment of Pain (EQUUS-DONKEY-FAP), in donkeys with acute pain. A cohort follow-up study using 264 adult donkeys (n = 12 acute colic, n = 25 acute orthopaedic pain, n = 18 acute head-related pain, n = 24 postoperative pain, and n = 185 controls) was performed. Both pain scales showed differences between donkeys with different types of pain and their control animals (p < 0.001). The EQUUS-DONKEY-COMPASS and EQUUS-DONKEY-FAP showed high inter-observer reliability (Cronbach’s alpha = 0.97 and 0.94, respectively, both p < 0.001). Sensitivity of the EQUUS-DONKEY-COMPASS was good for colic and orthopaedic pain (83% and 88%, respectively), but poor for head-related and postoperative pain (17% and 21%, respectively). Sensitivity of the EQUUS-DONKEY-FAP was good for colic and head-related pain (75% and 78%, respectively), but moderate for orthopaedic and postoperative pain (40% and 50%, respectively). Specificity was good for all types of pain with both scales (91%–99%). Different types of acute pain in donkeys can be validly assessed by either a composite or a facial expression-based pain scale.

Chronic pain in cats: Recent advances in clinical assessment

2019 ◽  
Vol 21 (7) ◽  
pp. 601-614 ◽  
Author(s):  
Beatriz P Monteiro ◽  
Paulo V Steagall
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Assessment ◽  
Negative Impact ◽  
Clinical Signs ◽  
Response To Therapy ◽  
Pain Mechanisms ◽  
Recent Advances ◽  
Pain Scales

Practical relevance: Chronic pain is a feline health and welfare issue. It has a negative impact on quality of life and impairs the owner–cat bond. Chronic pain can exist by itself or may be associated with disease and/or injury, including osteoarthritis (OA), cancer, and oral and periodontal disease, among others. Clinical challenges: Chronic pain assessment is a fundamental part of feline practice, but can be challenging due to differences in pain mechanisms underlying different conditions, and the cat’s natural behavior. It relies mostly on owner-assessed behavioral changes and time-consuming veterinary consultations. Beyond OA – for which disease-specific clinical signs have been described – little is known regarding other feline conditions that produce chronic pain. Recent advances: Knowledge of the subject has, however, greatly improved in the past few years, informed by study of the mechanisms of pain in cats with OA and the development of pain scales that can be used by owners or veterinarians. Pain scales may facilitate the diagnosis and follow-up evaluation of chronic painful conditions, providing a basis for therapeutic decision-making. Assessment of quality of life is also recommended in cats with chronic pain, and its improvement can be used as a positive outcome in response to therapy. Aims: This article reviews recent advances and presents the challenges and some future perspectives on clinical chronic pain assessment. The most common feline chronic conditions associated with pain are also described.

The Utility and Construct Validity of Four Measures of Pain Intensity: Results from a University-Based Study in Spain

Pain Medicine ◽  
2019 ◽  
Vol 20 (12) ◽  
pp. 2411-2420 ◽  
Author(s):  
Mark P Jensen ◽  
Elena Castarlenas ◽  
Rubén Roy ◽  
Catarina Tomé Pires ◽  
Mélanie Racine ◽  
...  
Keyword(s):  
Construct Validity ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Scale ◽  
Survey Study ◽  
Research Knowledge ◽  
Intensity Measures ◽  
Cultural Research ◽  
English Speaking

Abstract Objective Pain intensity is the most commonly assessed domain in pain research and clinical settings. To facilitate cross-cultural research, knowledge regarding the psychometric properties of pain intensity measures in individuals from different countries is needed. However, the majority of this research has been conducted in English-speaking countries. Design Survey study. Setting University. Subjects Four hundred nineteen college students. Methods Participants were asked to complete four measures assessing average pain intensity: 1) the 0–10 numerical rating scale (NRS-11), 2) the 100-mm visual analog scale (VAS), 3) the four-point verbal rating scale (VRS-4), and 4) the Faces Pain Scale–Revised (FPS-R). Results The rates of incorrect completion of the four scales were uniformly low (range = 1–2%). The NRS-11 had the highest preference rate (31%), although a substantial number of participants also preferred each of the other three scales (range = 22–24%). The findings support the utility and construct validity of all four pain intensity scales in this Spanish-speaking sample. Conclusions When considered in light of research from other non-English-speaking samples indicating significant psychometric weaknesses for the NRS-11 and VAS and relative strengths of the FPS-R in some groups, the findings suggest that the FPS-R might be the most appropriate pain intensity scale to use when comparisons across populations from different countries is a goal. More research is needed to determine the extent to which demographic (i.e., age, education levels, socioeconomic status) vs cultural factors (i.e., country of origin) influence the reliability, validity, and utility of different pain measures.

Comparison of Self-Reported and Behavioral Pain Assessment Tools in Critically Ill Patients

2018 ◽  
Vol 35 (5) ◽  
pp. 453-460 ◽  
Author(s):  
Rima H. Bouajram ◽  
Christian M. Sebat ◽  
Dawn Love ◽  
Erin L. Louie ◽  
Machelle D. Wilson ◽  
...  
Keyword(s):  
Critically Ill ◽  
Pain Assessment ◽  
Critically Ill Patients ◽  
Strong Correlation ◽  
Rating Scale ◽  
Assessment Method ◽  
Pain Scale ◽  
Assessment Tools ◽  
Pain Scales ◽  
Behavioral Pain Scale

Background:Self-reported and behavioral pain assessment scales are often used interchangeably in critically ill patients due to fluctuations in mental status. The correlation between scales is not well elucidated. The purpose of this study was to describe the correlation between self-reported and behavioral pain scores in critically ill patients.Methods:Pain was assessed using behavioral and self-reported pain assessment tools. Behavioral pain tools included Critical Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS). Self-reported pain tools included Numeric Rating Scale (NRS) and Wong-Baker Faces Pain Scales. Delirium was assessed using the confusion assessment method for the intensive care unit. Patient preference regarding pain assessment method was queried. Correlation between scores was evaluated.Results:A total of 115 patients were included: 67 patients were nondelirious and 48 patients were delirious. The overall correlation between self-reported (NRS) and behavioral (CPOT) pain scales was poor (0.30, P = .018). In patients without delirium, a strong correlation was found between the 2 behavioral pain scales (0.94, P < .0001) and 2 self-reported pain scales (0.77, P < .0001). Self-reported pain scale (NRS) and behavioral pain scale (CPOT) were poorly correlated with each other (0.28, P = .021). In patients with delirium, there was a strong correlation between behavioral pain scales (0.86, P < .0001) and a moderate correlation between self-reported pain scales (0.69, P < .0001). There was no apparent correlation between self-reported (NRS) and behavioral pain scales (CPOT) in patients with delirium (0.23, P = .12). Most participants preferred self-reported pain assessment.Conclusion:Self-reported pain scales and behavioral pain scales cannot be used interchangeably. Current validated behavioral pain scales may not accurately reflect self-reported pain in critically ill patients.

scholarly journals The Quality of Pain Treatment in Community-Dwelling Persons with Dementia

2015 ◽  
Vol 5 (3) ◽  
pp. 470-481 ◽  
Author(s):  
Jiwen Li ◽  
A. Lynn Snow ◽  
Nancy Wilson ◽  
Melinda A. Stanley ◽  
Robert O. Morgan ◽  
...  
Keyword(s):  
Pain Assessment ◽  
Medical Records ◽  
Pain Treatment ◽  
Pain Scale ◽  
Veterans Affairs ◽  
Community Dwelling ◽  
Pain Scales ◽  
Pain Care

Background/Aims: Despite pervasive and debilitating pain among elders, it is underassessed and undertreated; and cognitive impairment can add challenges. We assessed the quality of pain care for community-dwelling elderly patients with dementia. Methods: We phone interviewed 203 Veterans Affairs primary care outpatients with dementia and pain and reviewed medical records to score 15 quality indicators of pain assessment and management. Results: Pain assessment was documented for 98%, and a standard pain scale was used for 94%. Modified pain scales were rarely used. Though 70% self-reported pain of ‘quite bad' or worse, charts documented no pain in 64%. When pain was identified, treatment was offered to 80%; but only 59% had a follow-up assessment within 6 months. Nonpharmacological interventions were underused. Conclusion: Community-dwelling elders with dementia are underdiagnosed and undertreated for pain.

scholarly journals Acute pain in cats: Recent advances in clinical assessment

2018 ◽  
Vol 21 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Paulo V Steagall ◽  
Beatriz P Monteiro
Keyword(s):  
Acute Pain ◽  
Pain Assessment ◽  
Pain Scale ◽  
Treatment Standards ◽  
Future Directions ◽  
Recent Advances ◽  
Pain Scales ◽  
Species Specific ◽  
Pain Recognition ◽  
Development And Validation

Practical relevance: Pain assessment has gained much attention in recent years as a means of improving pain management and treatment standards. It has become an elemental part of feline practice with ultimate benefit to feline health and welfare. Currently pain assessment involves mostly the investigation of sensory-discriminative (intensity, location and duration) and affective-motivational (emotional) domains of pain. Specific behaviors associated with acute pain have been identified and constitute the basis for its assessment in cats. Recent advances: The publication of pain scales with reported validation – the UNESP-Botucatu multidimensional composite pain scale and the Glasgow feline composite measure pain scale – and species-specific studies have advanced our knowledge on the subject. Facial expressions have also been shown to be different between painful and non-painful cats, and very recently the Feline Grimace Scale has been validated as a tool for acute pain assessment. Clinical challenges: Despite recent advances, several challenges still exist. For instance, the effects of disease and sedation on pain scoring/ assessment are unknown. Also, specific painful conditions (eg, dental pain) have not been systematically investigated. The development and validation of instruments for pain assessment by cat owners is warranted, as these tools are currently lacking. Aims: This article reviews the use, advantages, disadvantages and limitations of the two validated pain scales, and presents a practical, stepwise approach to feline pain recognition and assessment using a dynamic and interactive process. The authors also offer perspectives regarding current challenges and future directions.

scholarly journals Objective Assessment of Acute Pain in Foals Using a Facial Expression-Based Pain Scale

Animals ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 1610
Author(s):  
Johannes van Loon ◽  
Nicole Verhaar ◽  
Els van den Berg ◽  
Sarah Ross ◽  
Janny de Grauw
Keyword(s):  
Facial Expression ◽  
Acute Pain ◽  
Pain Assessment ◽  
Objective Assessment ◽  
Diagnostic Procedures ◽  
Pain Scale ◽  
Video Recordings ◽  
Pain Scores ◽  
Flunixin Meglumine ◽  
Pain Scales

Pain assessment is very important for monitoring welfare and quality of life in horses. To date, no studies have described pain scales for objective assessment of pain in foals. Studies in other species have shown that facial expression can be used in neonatal animals for objective assessment of acute pain. The aim of the current study was to adapt a facial expression-based pain scale for assessment of acute pain in mature horses for valid pain assessment in foals. The scale was applied to fifty-nine foals (20 patients and 39 healthy controls); animals were assessed from video recordings (30–60 s) by 3 observers, who were blinded for the condition of the animals. Patients were diagnosed with acute health problems by means of clinical examination and additional diagnostic procedures. EQUUS-FAP FOAL (Equine Utrecht University Scale for Facial Assessment of Pain in Foals) showed good inter- and intra-observer reliability (Cronbach’s alpha = 0.95 and 0.98, p < 0.001). Patients had significantly higher pain scores compared to controls (p < 0.001) and the pain scores decreased after treatment with NSAIDs (meloxicam or flunixin meglumine IV) (p < 0.05). Our results indicate that a facial expression-based pain scale could be useful for the assessment of acute pain in foals. Further studies are needed to validate this pain scale.

scholarly journals The importance of professional based questionnaire in the dog’s acute and chronic pain evaluation

2021 ◽  
Vol 72 (3) ◽  
pp. 3229
Author(s):  
AK MARKOVSZKY ◽  
M DANES ◽  
E DUMITRESCU ◽  
F MUSELIN ◽  
AC STANCU ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Drug Therapy ◽  
Acute Pain ◽  
Short Form ◽  
Pain Scale ◽  
Pain Patient ◽  
Physiotherapy Treatment ◽  
Chronic Patients ◽  
Pain Evaluation ◽  
Reduction Of Pain

The measurement of pain levels is made differently depending if acute or chronic pain is diagnosed, objective (e.g. cortisol, prolactin, serotonin, catecholamines, or the cardiac frequency and arterial pressure evaluation) or subjective methods being imagined. All subjective methods are including questionnaires and specific additional methods. The aim was the verifying the effectiveness of drug and physiotherapy combinations by using an owner based questionnaire for the chronic patients and a veterinary professional based questionnaire for the acute pain patient group. In this study a total of 20 dogs with observable pain were selected and two groups (n = 10 / group), constituted: G1 - chronic pain, and G2 - acute pain. The treatment of dogs with acute signs of pain was made oral or injectable with NSAIDs administration and for dogs with signs of chronic pain, physiotherapy treatment and drug therapy was administered. The owners of the dogs with chronic pain received the HCPI questionnaire in order to evaluate their dog’s pain level subjectively. For the dogs with acute pain the veterinarian filled out the short form of Glasgow Composite Measure Pain Scale (CMPS-SF). After initiating a Paired t-test in Excel 2010 with the scores obtained with HCPI and CMPS-SF, there was observed a significant reduction of pain after associated drug administration and physiotherapy and no significant evidence of acute pain after drug therapy. The used physiotherapy and drug combinations delivered a significant reduction of chronic pain, both clinically and visually mirrored in score reduction after treatments. The HCPI questionnaire could be considered a valuable tool for evaluating chronic pain in patients in the clinic environment. The CMPS-SF has also proven to be a very useful questionnaire in diagnose of acute pain and evaluation of the effectiveness of drug therapy used.

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