数字疼痛量表和描述疼痛量表的相关性研究和改进

目的 探讨“长海痛尺”的科学性和可行性。方法 研究证明数字疼痛量表（NRS）和描述疼痛量表（VRS）的相关性，并设计“长海痛尺”。结果 NRS和VRS之间相关性良好，相关系数r为0.8241。结论 “长海痛尺”的设计具有一定的科学依据，且具有简便、易理解、结果相对准确的特点，可以满足临床一线工作的需要。     

三种疼痛强度评估量表应用于结核外科手术患者的首选率、重测信度及同时效度分析

目的分析三种疼痛强度评估量表应用于结核外科手术患者的首选率、重测信度及同时效度。方法选择2018年12月至2019年12月在我院行手术治疗的102例结核病患者。通过数字评价量表(NRS)、长海痛尺及Prince-Henry疼痛量表评估患者术后24 h的疼痛情况,并比较不同量表的首选率、重测信度及同时效度。结果NRS、长海痛尺、Prince-Henry的首选率分别为长海痛尺32.35%、35.29%、32.35%,差异无统计学意义(P>0.05);不同性别患者对3种量表的首选率无显著差异(P>0.05);不同年龄患者对三种量表的首选率存在差异,不同文化程度患者对NRS、Prince-Henry的首选率存在差异(P<0.05)。三种量表的重测信度均较高,具体顺序为长海痛尺>Prince-Henry>NRS(P<0.05)。长海痛尺、Prince-Henry均呈现出与NRS高度相关(P<0.05)。结论长海痛尺在结核外科手术患者中应用的首选率、重测信度及同时效度均较高,可以作为结核外科手术患者术后疼痛评估的首选量表。     

5种疼痛强度评估量表在血管外科病人中的易用性比较

[目的]比较常用疼痛强度评估量表在血管外科病人中易用情况,为选择适合血管外科病人的量表提供客观依据.[方法]采用便利取样的方法对北京市三级甲等医院血管外科病区102例住院病人用视觉模拟量表(VAS)、词语描述量表(VRS-4)、数字评定量表(NRS)、Wong-Baker面部表情疼痛量表(FPS-R)和长海痛尺评估病人现有疼痛或3 d内记忆中最深刻的1次疼痛强度.[结果]FPS-R是血管外科病人中首选率最高(58.8%)、最直观次易懂(73.5%)及最准确具体(52.0%)的量表;FPS-R、VRS是成功应答人数最高(101例、94例)及解释次数最少(1.05次±0.2次、1.10次±0.3次)的量表,较其他3种量表具有统计学意义(P<0.01);仅FPS-R的成功应答率和解释次数在不同年龄、性别及文化程度病人中无差异,不具统计学意义(P>0.05);5种量表疼痛评分的Spearman相关系数为0.79～0.93.[结论]5种疼痛评估量表均可用于血管外科病人的疼痛强度评估,但FPS-R是最合适的量表.     

老年人疼痛强度评估量表的选择

目的:调查老年人使用4种常用疼痛强度评估量表的情况,为选择合适的老年疼痛评估工具提供依据.方法:广州市两家老人院的61例65岁以上老年人参加了研究.用随机顺序排列的直观模拟量表(VAS)、数字评定量表(NRS)、词语描述量表(VDS)和修订版面部表情疼痛量表(FPS-R),对老年人的回忆性疼痛进行评估.结果:受试对象中男性17例,女性44例,平均年龄81.7岁,54例(88.5%) 认知正常,7例(11.5%)有一定程度的认知受损.4种量表疼痛评分间的Spearman相关系数为0.84～0.94.老年人能够用至少一种量表来主诉疼痛强度.FPS-R是错误率最低而首选率最高的量表.结论:4种量表均可用于评估老年人的疼痛,但FPS-R是最佳量表.将FPS-R、VDS和NRS 3种量表合并,制成简易疼痛评估尺,适合老年人认知功能且实用的疼痛评估方法.     

疼痛评估量表在癌症疼痛病人中的应用

[目的]探讨疼痛评估量表在癌症疼痛病人中的应用.[方法]对152例癌症疼痛病人采用数字分级法(NRS)与修订版面部表情法(FPS-R)进行疼痛评估与临床监控.[结果]首次评估NRS评分平均5.6分,经规范化止痛治疗后,疼痛完全缓解92例,部分缓解48例,未缓解12例.[结论]疼痛评估量表能直观、动态地反映病人疼痛变化过程、疼痛部位及性质,同时对疼痛的治疗和护理干预具有很好的指导作用.     

视觉模拟量表和语言评价量表用于术后疼痛评估的比较

目的探讨是否可以使用简单的语言评价量表代替视觉模拟量表进行手术后疼痛的评估。方法将美国麻醉医师协会(ASA)Ⅰ -Ⅲ级的120例患者依其受教育程度的高低分2组 :初中及初中以下文化程度组(Ⅰ组 ,n=45) ,高中及高中以上文化程度组 (Ⅱ组 ,n=75)。患者于术后进行视觉模拟量表(VAS)和语言评价量表(VRS)的填写。麻醉医生对如何进行量表的填写向患者进行解释 ,并记录以下数据 :每位患者VAS和VRS的数值 ,填写VAS和VRS量表前向患者解释的次数 (Nvas和Nvrs)。结果Ⅰ组和Ⅱ组的VAS和VRS评分均有显著相关性 (P<0.01) ,其相关系数分别为0.936和0.901。在Ⅰ组中Nvas较Nvrs高 (P<0.05) ,同时Nvas在Ⅰ组中较Ⅱ组中高 (P<0.05) ,但在Ⅱ组中Nvas和Nvrs无显著差异(P>0.05)。结论在对患者进行术后疼痛评定时VRS和VAS具有良好的相关性 ,而VRS更适用于文化程度低及抽象概念理解有困难的患者 ,如老人     

5种疼痛强度评估量表在血管外科病人中的易用性比较

[目的]比较常用疼痛强度评估量表在血管外科病人中易用情况,为选择适合血管外科病人的量表提供客观依据。[方法]采用便利取样的方法对北京市三级甲等医院血管外科病区102例住院病人用视觉模拟量表（VAs）、词语描述量表（VRS-4）、数字评定量表（NRS）、Wong-Baker面部表情疼痛量表（FPS—R）和长海痛尺评估病人现有疼痛或3d内记忆中最深刻的1次疼痛强度。[结果]FPS—R是血管外科病人中首选率最高（58．8％）、最直观次易懂（73．5％）及最准确具体（52．0％）的量表;FPS—R、VRS是成功应答人数最高（101例、94例）及解释次数最少（1．05次&#177;0．2次、1．10次&#177;0．3次）的量表,较其他3种量表具有统计学意义（P〈0．01）;仅FPS—R的成功应答率和解释次数在不同年龄、性别及文化程度病人中无差异,不具统计学意义（P〉0．05）;5种量表疼痛评分的Spearman相关系数为0．79～0．93。[结论]5种疼痛评估量表均可用于血管外科病人的疼痛强度评估,但FPS—R是最合适的量表。     

"长海痛尺"在疼痛评估中的应用

目的 探讨“长海痛尺”在临床应用中的可行性和实用性。方法 设计“长海痛尺”并将其应用于临床6个月后，调查评估及患对此量表的评价。结果 疼痛评估对“长海痛尺”的满意度为88．28％，患对“长海痛尺”的满意度为90％。结论 “长海痛尺”设计合理，使用方便，在疼痛评估时能更好地满足医护人员及患的需要。     

疼痛评估量表在癌症疼痛病人中的应用

[目的]探讨疼痛评估量表在癌症疼痛病人中的应用。[方法]对152例癌症疼痛病人采用数字分级法（NRS）与修订版面部表情法（FPS-R）进行疼痛评估与临床监控。[结果]首次评估NRS评分平均5.6分,经规范化止痛治疗后,疼痛完全缓解92例,部分缓解48例,未缓解12例。[结论]疼痛评估量表能直观、动态地反映病人疼痛变化过程、疼痛部位及性质,同时对疼痛的治疗和护理干预具有很好的指导作用。     

疼痛强度评估量表应用于老年腰痛患者的同时效度与偏好性

目的探讨疼痛强度评估量表在老年腰痛患者疼痛评估中的同时效度与选择量表时的偏好。方法由测评人员对30例有腰痛临床症状的老年患者进行疼痛强度评估量表测试,包括数字评定量表(NRS)、视觉模拟评分表(VAS)、词语描述量表(VDS)、修改版面部表情疼痛量表(FPS-R)和组合型疼痛评估表(MIX)。以NRS为校标工具,通过Spearman相关系数检验NRS与FPS-R、MIX、VAS和VDS之间的相关程度来确定FPS-R、MIX、VAS和VDS的同时效度。统计患者对5种评估量表的首选率。结果 FPS-R、MIX、VAS和VDS与NRS高度正相关(r=0.753～0.957,P<0.001)。首选疼痛强度评估量表依次为FPS-R、NRS、VDS、MIX、VAS。结论 FPS-R、MIX、VAS和VDS具有良好的同时效度,疼痛强度评估量表的同时效度适用于老年腰痛人群的评估。FPS-R是首选率最高的量表。     

The Research on the Correlation between the Numerical Rating Scale and Verbal Rating Scale and the Improvement on Pain Assessment

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Pain: a review of three commonly used pain rating scales

Aims and objectives. This review aims to explore the research available relating to three commonly used pain rating scales, the Visual Analogue Scale, the Verbal Rating Scale and the Numerical Rating Scale. The review provides information needed to understand the main properties of the scales. Background. Data generated from pain‐rating scales can be easily misunderstood. This review can help clinicians to understand the main features of these tools and thus use them effectively. Method. A MedLine review via PubMed was carried out with no restriction of age of papers retrieved. Papers were examined for methodological soundness before being included. The search terms initially included pain rating scales, pain measurement, Visual Analogue Scale, VAS, Verbal Rating Scale, VRS, Numerical/numeric Rating Scale, NRS. The reference lists of retrieved articles were used to generate more papers and search terms. Only English Language papers were examined. Conclusions. All three pain‐rating scales are valid, reliable and appropriate for use in clinical practice, although the Visual Analogue Scale has more practical difficulties than the Verbal Rating Scale or the Numerical Rating Scale. For general purposes the Numerical Rating Scale has good sensitivity and generates data that can be statistically analysed for audit purposes. Patients who seek a sensitive pain‐rating scale would probably choose this one. For simplicity patients prefer the Verbal Rating Scale, but it lacks sensitivity and the data it produces can be misunderstood. Relevance to clinical practice. In order to use pain‐rating scales well clinicians need to appreciate the potential for error within the tools, and the potential they have to provide the required information. Interpretation of the data from a pain‐rating scale is not as straightforward as it might first appear.     

Validity of four pain intensity rating scales

The Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and the Faces Pain Scale-Revised (FPS-R) are among the most commonly used measures of pain intensity in clinical and research settings. Although evidence supports their validity as measures of pain intensity, few studies have compared them with respect to the critical validity criteria of responsivity, and no experiment has directly compared all 4 measures in the same study. The current study compared the relative validity of VAS, NRS, VRS, and FPS-R for detecting differences in painful stimulus intensity and differences between men and women in response to experimentally induced pain. One hundred twenty-seven subjects underwent four 20-second cold pressor trials with temperature order counterbalanced across 1°C, 3°C, 5°C, and 7°C and rated pain intensity using all 4 scales. Results showed statistically significant differences in pain intensity between temperatures for each scale, with lower temperatures resulting in higher pain intensity. The order of responsivity was as follows: NRS, VAS, VRS, and FPS-R. However, there were relatively small differences in the responsivity between scales. A statistically significant sex main effect was also found for the NRS, VRS, and FPS-R. The findings are consistent with previous studies supporting the validity of each scale. The most support emerged for the NRS as being both (1) most responsive and (2) able to detect sex differences in pain intensity. The results also provide support for the validity of the scales for use in Portuguese samples.     

Validity,Reliability, and Diagnostic Accuracy of the Respiratory Distress Observation Scale for Assessment of Dyspnea in Adult Palliative Care Patients

Background

The prevalence and severity of dyspnea increase at the end of life. Many of these patients have difficulty in reporting their symptoms. Accurate surrogate measures are needed for appropriate assessment and treatment. The Respiratory Distress Observation Scale (RDOS) is proposed as a possible scale although more external validation is needed. We set out to validate the RDOS in the context of palliative care patients near the end of life.

Three new datasets supporting use of the Numerical Rating Scale (NRS-11) for children’s self-reports of pain intensity

Despite wide usage of the Numerical Rating Scale (NRS) for self-report of pain intensity in clinical practice with children and adolescents, validation data are lacking. We present here three datasets from studies in which the NRS was used together with another self-report scale. Study A compared post-operative pain ratings on the NRS with scores on the Faces Pain Scale-Revised (FPS-R) in 69 children age 7–17 years who had undergone a variety of surgical procedures. Study B compared post-operative pain ratings on the NRS with scores on the Visual Analogue Scale (VAS) in 29 children age 9–17 years who had undergone pectus excavatum repair. Study C compared ratings of remembered immunization pain in 236 children who comprised an NRS group and a sex- and age-matched VAS group. Correlations of the NRS with the FPS-R and VAS were r = 0.87 and 0.89 in Studies A and B, respectively. In Study C, the distributions of scores on the NRS and VAS were very similar except that scores closest to the no pain anchor were more likely to be selected on the VAS than the NRS. The NRS can be considered functionally equivalent to the VAS and FPS-R except for very mild pain (<1/10). We conclude that use of the NRS is tentatively supported for clinical practice with children of 8 years and older, and we recommend further research on the lower age limit and on standardized age-appropriate anchors and instructions for this scale.     

全科理念下基于Barthel指数评定量表在中老年高血压合并脑卒中患者康复护理中的应用

目的:探讨全科理念下基于Barthel指数评定量表在中老年高血压合并脑卒中患者康复护理中应用效果。方法:选取2017年1月至2018年12月在南京医科大学附属无锡第二医院的中老年高血压合并脑卒中患者110例,随机分为干预组和对照组,各55例。对照组患者接受常规的临床护理及健康教育,干预组患者经全科理念下Barthel指数评定量表开展康复护理。对两组患者治疗护理前,护理后3个月的血压水平、神经功能、肢体运动功能及日常生活活动能力进行对比分析。结果:护理后3个月两组患者的DBP、SBP水平均下降,干预组低于对照组;护理后3个月两组患者的神经功能、肢体运动功能改善,干预组改善效果优于对照组;护理后3个月两组患者的日常生活活动能力MBI评分均增高,且干预组高于对照组,差异有统计学意义(P<0.05)。结论:全科理念下基于Barthel指数评定量表在中老年高血压合并脑卒中患者康复护理中应用效果显著,能调节患者血压水平,促进患者神经功能、肢体运动功能恢复,增强患者的日常生活活动能力,从而改善患者日常生活质量。     

Persian translation and validation of the Back Pain Functional Scale

Background: Patient-reported questionnaires provide important tools that can be utilized for the assessment of treatment efficacy in clinic and research. This study aimed to translate, cross-culturally adapt, and validate the Back Pain Functional Scale into Persian (BPFSp). Methods: In this cross-sectional and prospective cohort of adult patients with low back pain (LBP), the translation and adaptation was performed according to standardized guidelines and pretested (n = 30). Psychometric testing was conducted with 100 patients with LBP and 50 healthy subjects. Fifty patients with LBP recompleted the BPFSp at least 7 days later for test–retest reliability. Results: The Persian adapted version of the BPFS was produced and validated. No floor and ceiling effects were revealed. The Cronbach’α coefficient for internal consistency was 0.895. The test–retest reliability was excellent (ICC_agreement = 0.88, CI 95%: 0.80–0.93). The standard error of measurement and smallest detectable change were 9.9% and 27.5%, respectively. Construct convergent validity was demonstrated with the Persian Functional Rating Index (r = ?0.77). Criterion validity was established with the Numerical Pain Rating Scale (r = ?0.67). Total BPFSp scores discriminated between patients with LBP and healthy subjects. Factor structure showed two latent factors explaining a total variance of 60.1%. Conclusion: The BPFSp presented excellent reliability and validity for assessing the functional status in Persian speaking patients with LBP.     

Brazilian Version of Cancer Fatigue Scale: Validation of the Brazilian Version of Cancer Fatigue Scale in Patients With Breast Cancer

ContextScales to assess the fatigue in patients with cancer may help the clinical decision-making process.ObjectivesThe objective of this study was to cross-culturally adapt and determine the validity of the Brazilian version of Cancer Fatigue Scale.MethodsTranslation and cross-cultural adaptation followed the recommendations of international guidelines. One hundred fifty-one women with breast cancer participated in the validity phase and they filled out the Brazilian version of another instruments (Piper Fatigue Scale Revised, Beck Depression Inventory, Verbal Numerical Rating Scale, and Karnofsky Performance Scale). The measurement properties of reliability, internal consistency, and validity were measured.ResultsThe few discrepancies identified in the back-translation were solved by consensus, and the Cancer Fatigue Scale was successfully translated and cross-culturally adapted. The Brazilian version of Cancer Fatigue Scale showed good stability (test-retest reliability intraclass correlation coefficient = 0.95, 95% CI = 0.94–0.97 and interexaminer reliability intraclass correlation coefficient = 0.98, 95% CI = 0.97–0.99) and good internal consistency (Cronbach's alpha >0.70 for the three subscales/domains). The high correlation was found with Piper Fatigue Scale (r = 0.643) and Beck Depression Inventory (r = 0.509) in terms of validity. However, a reasonable correlation was found with Verbal Numerical Rating Scale (r = 0.302) and Karnofsky Performance Scale (r = −0.324).ConclusionHere, we validated the Cancer Fatigue Scale in breast cancer Brazilian women meaning its use for the identification and evaluation of cancer-related fatigue in patients with breast cancer.