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。     

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.     

五指法在疼痛强度评估中的应用

目的探索一种新的疼痛评估方法,使患者对疼痛强度能更简便、真实地描述.方法采用数字评定法(NRS)、词语描述法(VDS)、修订版面部表情法(FPS-R)和疼痛强度评估新法--五指法,让144例外科患者对自己的疼痛强度进行描述,最后选择最佳的评估方法.结果首选率最高的是五指法,84例,占58.3%;首选VDS的30例,占20.8%;NRS 16例,占 11.1%;FPS-R 14例,占9.7%.综合评价指标由高到低依次为五指法、FPS-R、 NRS、 VDS.结论 4种疼痛评估方法比较,五指法首选率和综合评价指标最高,可作为临床上评估疼痛强度的客观指标.     

中文版吞咽障碍造影评分量表的信度和效度研究

目的:汉化吞咽障碍造影评分量表(videofluoroscopic dysphagia scale,VDS)并分析其信度和效度,为评估脑卒中患者吞咽障碍提供简单、有效的工具。方法:对英文版VDS进行翻译和文化调适,并采用中文版VDS对47例脑卒中患者进行评估,对其结果进行信度和效度分析。结果:中文版VDS量表总体Cronbach’sα系数为0.769,各维度的Cronbach’sα系数是0.707—0.912;重测信度总体的组内相关系数(intraclass correlation coefficient,ICC)为0.951,各条目的ICC为0.732—1.000;测量者间信度总体的ICC为0.731,各条目的ICC为0.703—0.877;每一个条目与其所在维度的相关系数为0.721—0.854(P<0.01),每一个条目与其所在维度的相关系数均高于其他维度的相关系数;结构效度采用因子分析,共提取出4个公因子,累积贡献率为64.59%;通过spearman相关分析其外部效度发现中文版VDS量表结果与中文版经口摄食功能评估量表结果、健康调查简表结果相关。结论:中文版VDS量表在...     

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。     

脊髓损伤痉挛评估量表的信度及各量表间的相关性分析

目的 探讨分析脊髓损伤痉挛状态评估工具(SCI-SET)量表、改良Penn痉挛频率(MPSFS)量表、脊髓痉挛性反应评估工具(SCATS)量表和目测类比法量表(VAS)评估脊髓损伤患者肌肉痉挛的信度及各量表间相关性。 方法 2位治疗师分别应用上述4个量表对35例脊髓损伤患者的痉挛情况进行评估。首先,第一位物理治疗师应用上述4个量表对患者的肌肉痉挛情况进行第1次评估,另一位物理治疗师在第一位物理治疗师评估结束约半个小时后对患者再进行1次评估。3d后,由第一位物理治疗师在相同时间段和环境下对所有患者进行第2次重复评估。计算各量表重复评估及不同测试者间评估的组内相关系数（ICC）及其相应的测量标准误（SEM）、最小可测得差异值（MDD95）,分析第一位治疗师首次评估结果各量表间的相关性。 结果 SCI-SET量表的重测信度和不同测试者间的信度均为优秀（ICC=0.969和0.989）;MPSFS量表的重测信度为优秀（ICC=0.940）,不同测试者间的信度为好（ICC=0.898）;SCATS量表的重测信度和不同测试者间的信度均为优秀（ICC=0.948和0.939）;VAS量表评估痉挛的重测信度和不同测试者间的信度均为优秀（ICC=0.962和0.974）。SCI-SET、MPSFS、SCATS以及VAS等脊髓损伤痉挛评估量表的相关性分析结果显示,各痉挛量表间均有显著相关性（P<0.05）,其中SCI-SET与其它量表间呈负相关,而其余各量表间均呈正相关。SCI-SET与MPSFS间（r=-0.421）、SCI-SET与SCATS间（r=-0.457）以及MPSFS与SCATS间（r=0.498）呈中等相关性,而其它量表两两之间相关性较高（r=0.548～0.938）,且差异均有统计学意义（P<0.05）。 结论 MPSFS、SCATS、VAS 和SCI-SET量表具有良好的重测信度和测试者间信度,适用于脊髓损伤后痉挛的评估。     

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.     

四种上肢功能评定量表用于脑卒中患者的信度研究

目的探讨脑卒中偏瘫患者Fugl-Meyer量表上肢运动功能测试部分(U-FMA)、Wolf运动功能测试量表(WMFT)、组块测试(BBT)及九孔柱测试 (NHPT)间不同评定次数的重测信度和不同评价者间的组间信度。 方法选取18例脑卒中患者,2 h内应用上述4种量表对每例患者进行2次评定,每次评定均由2名受过专业训练的评定员分别进行。 结果U-FMA的重测信度组内相关系数（ICC）为0.988,组间信度ICC为0.959;WMFT的计时均数和计时中位数重测信度ICC分别为0.996和0.393,组间信度ICC均为1.000;WMFT的动作质量等级评分均数重测信度ICC为0.989,组间信度ICC为0.977;BBT患手计数及患手与健手差值的重测信度ICC分别为0.975和0.982;NHPT患手计时及患手与健手计时差值的重测信度ICC分别为0.937和0.936,组间信度ICC均为1.000。 结论U-FMA、WMFT、BBT及九孔柱测试均具有良好的重测信度和组间信度,适用于脑卒中患者手部功能的临床评价。     

连续性评估记录和评价（CARE）量表中文版在脑卒中评定中的信度研究

目的:应用美国连续性评估记录和评价(the continuity assessment record and evaluation,CARE)量表(住院期间)中文版评定脑卒中患者功能障碍,进行该量表的信度研究。方法:选择30例脑卒中住院患者,其中脑出血恢复期7例,脑梗死恢复期23例,应用CARE量表(住院期间)中文版,分别研究评测者间信度和重测信度。结果:评测者间信度方面,认知功能、日常生活自理能力、移动能力及膀胱与肠道控制能力的组内相关系数(the intra-group correlation coefficient,ICC)0.602—0.997;重测信度方面,认知功能、日常生活自理能力、移动能力及膀胱与肠道控制能力的组内相关系数(ICC)为0.654—1.000。结论:CARE量表(住院期间)中文版评估脑卒中恢复期患者各方面的功能障碍具有良好的信度,可帮助康复工作者制定更加实际的康复目标和康复治疗方案。     

Measurement Properties of Visual Analogue Scale,Numeric Rating Scale,and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review

The Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), and Pain Severity subscale of the Brief Pain Inventory (BPI-PS) are the most frequently used instruments to measure pain intensity in low back pain. However, their measurement properties in this population have not been reviewed systematically. The goal of this study was to provide such systematic evidence synthesis. Six electronic sources (MEDLINE, EMBASE, CINAHL, PsycINFO, SportDiscus, Google Scholar) were searched (July 2017). Studies assessing any measurement property in patients with nonspecific low back pain were included. Two reviewers independently screened articles and assessed risk of bias using the COSMIN checklist. For each measurement property, evidence quality was rated as high, moderate, low, or very low (GRADE approach) and results were classified as sufficient, insufficient, or inconsistent. Ten studies assessed the VAS, 13 the NRS, 4 the BPI-PS. The 3 instruments displayed low or very low quality evidence for content validity. High-quality evidence was only available for NRS insufficient measurement error. Moderate evidence was available for NRS inconsistent responsiveness, BPI-PS sufficient structural validity and internal consistency, and BPI-PS inconsistent construct validity. All VAS measurement properties were underpinned by no, low, or very low quality evidence; likewise, the other measurement properties of NRS and BPI-PS.

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.     

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.     

Reliability and validity of the Faces Pain Scale with older adults

BACKGROUND: The Faces Pain Scale (FPS) is effective with older adults in clinical assessment of pain intensity. The 0-10 numerical rating scale (NRS) has universally adapted for assessment of pain intensity. The commonly used versions of the FPS have six, seven or nine faces. OBJECTIVES: We proposed an 11 face modified version of the McGrath nine face FPS to compare with the 0-10 NRS without the mathematical translation. The psychometric properties of the proposed version were also investigated in a sample of Korean older adults. DESIGN: This study employed methodological research design. SETTINGS AND PARTICIPANTS: A sample of 31 older adults was recruited through local senior citizen centers to examine the construct validity and the test-retest reliability. For the concurrent validity testing, a sample of 85 older adults with chronic pain was recruited through a general hospital and an oriental medical hospital. METHODS: The construct validity was examined by determining if the subjects perceive the FPS as representing pain and they agree on the rank of each face. The test-retest reliability was examined at a 2-week interval. The concurrent validity was examined by using the NRS and the Visual Analogue Scale (VAS). RESULTS: Subjects perceived the 11 FPS as a pain measure, and the subjects' agreements in the rank ordering of the faces were almost perfect (Kendall's W = .93, p < .001). Cohen's kappa of .61 (p < .001) for test-retest reliability was acceptable in the cognitively intact subjects. Concurrent validity measured by the correlation between the FPS and the NRS (r = .73, p < .001) and the VAS (r = .73, p < .001) was supported. CONCLUSIONS: These results supported the appropriateness of the 11 FPS for use with the older adults in clinical practice to measure pain intensity. Additionally, this study provided cross-cultural evidence to evaluate usefulness of the FPS.