老年人疼痛强度评估量表的选择

The selection of pain intensity assessment scales in Chinese elders

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 6 1例 6 5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 4 4例 ,平均年龄 81.7岁 ,5 4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 。

Objectives: To investigate the usefulness of four commonly used pain intensity assessment scales in Chinese older adults, and provide data for selecting the right tool to assess elderly pain. Method: A convenience sample of 61 older adults was recruited for this study. A remembered pain was measured with four pain assessment scales laid out in random order: the Visual Analog Scale (VAS), Numeric Rating Scale (NRS), Verbal Descriptor Scale (VDS) and Faces Pain Scale Revised (FPS R). Results: The sample consisted of 17 males and 44 females with a mean age of 81.7 years. Fifty four (88.5%) were cognitively intact, seven (11.5%) had some degree of cognitive impairment. Spearman rank correlation coefficients between pain ratings on the four scales ranged from 0.84 to 0.94. The elder could use at least one scale to report pain intensity. FPS R had the lowest error rate and highest scale preference. Conclusions: The findings suggest that all four scales can be used to assess elderly pain, but FPS R emerges as the best scale. A mini pain assessment ruler that incorporates a FPS R, NRS and VDS may be cognitively appropriate and practical to assess elderly pain.