scholarly journals Assessing Pain Intensity in Children with Chronic Pain: Convergent and Discriminant Validity of The 0 To 10 Numerical Rating Scale in Clinical Practice

2014 ◽  
Vol 19 (3) ◽  
pp. 141-148 ◽  
Author(s):  
Danielle Ruskin ◽  
Chitra Lalloo ◽  
Khushnuma Amaria ◽  
Jennifer N Stinson ◽  
Erika Kewley ◽  
...  

BACKGROUND: In clinical practice, children are often asked to rate their pain intensity on a simple 0 to 10 numerical rating scale (NRS). Although the NRS is a well-established measure for adults, no study has yet evaluated its validity for children with chronic pain.OBJECTIVES: To examine the convergent and discriminant validity of the NRS as it is used within regular clinical practice to document pain intensity for children with chronic pain. Interchangeability between the NRS and an analogue pain measure was also assessed.METHODS: A cohort of 143 children (mean [± SD] age 14.1±2.4 years; 72% female) rated their pain intensity (current, usual, lowest and strongest levels) on a verbally administered 0 to 10 NRS during their first appointment at a specialized pain clinic. In a separate session that occurred either immediately before or after their appointment, children also rated their pain using the validated 0 to 10 coloured analogue scale (CAS).RESULTS: NRS ratings met a priori criteria for convergent validity (r>0.3 to 0.5), correlating with CAS ratings at all four pain levels (r=0.58 to 0.68; all P<0.001). NRS for usual pain intensity differed significantly from an affective pain rating, as hypothesized (Z=2.84; P=0.005), demonstrating discriminant validity. The absolute differences between NRS and CAS pain scores were small (range 0.98±1.4 to 1.75±1.9); however, the two scales were not interchangeable.CONCLUSIONS: The present study provides preliminary evidence that the NRS is a valid measure for assessing pain intensity in children with chronic pain.

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1184
Author(s):  
Jessica Finianos ◽  
Elisabet Sánchez-Rodríguez ◽  
Jordi Miró

The Faces Pain Scale-Revised (FPS-R) is widely used to assess pain intensity in young people. The aims of this research were to study the convergent and discriminant validity and reliability properties of a culturally adapted version of the FPS-R for its use with Arabic-speaking individuals. The sample consisted of 292 students living in Lebanon. They were interviewed online, asked to imagine themselves in one of two given situations based on their age (8–12 and 13–18 years old), and then asked rate the intensity of pain they would experience using the FPS-R-Arabic and a Numerical Rating Scale (NRS-11-Arabic). They were also asked to respond to the Pain Catastrophizing Scale (PCS-C-Arabic). Two weeks later, participants were asked to repeat the same procedure. The data showed strong associations between the scores of the FPS-R-Arabic and NRS-11-Arabic (r = 0.72; p < 0.001), which were higher than the associations of the scores of the FPS-Arabic with the PCS-C-Arabic scores (z = 7.36, p < 0.001). The associations between the FPS-R-Arabic scores on the two measurements were also strong (r = 0.76; p < 0.001). The findings support the convergent and discriminant validity and reliability of the FPS-R-Arabic scores when used to measure pain intensity in young people aged 8 to 18 years old.


Author(s):  
Felicia Cox

The landmark paper discussed in this chapter is ‘Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale’, published by Farrar et al. in 2001. The numerical rating scale is now the standard instrument used in chronic pain studies to measure pain intensity. Farrar et al. determined the changes in pain intensity that were clinically significant for studies of chronic pain while measuring the patient’s global impression of change. The paper used pooled data from ten recent studies of pregabalin in 2,724 subjects. The authors reported a consistent relationship between pain intensity and patient global impression of change, regardless of study, disease type, age, sex, study result, or treatment group. A reduction of approximately two points on the numerical rating scale, or of 30% in the global impression of change of pain intensity, represented a clinically important difference.


Author(s):  
Dariusz Kosson ◽  
Małgorzata Malec-Milewska ◽  
Robert Gałązkowski ◽  
Patryk Rzońca

The aim of the study was to measure the frequency of such emotional disturbances as anxiety, depression and aggression among patients treated in a pain clinic, as well as assess the factors contributing to such disorders. Research was conducted from January 2014 to April 2018 and involved patients treated in two pain clinics in the city of Warsaw, Poland. The study used the Hospital Anxiety and Depression Scale—Modified Version (HADS-M) and the Numerical Rating Scale (NSR). 1025 patients were recruited. The main reasons for their attending the pain clinic were osteoarticular pain (43.61%) and neuropathic pain (41.56%). Emotional disturbances in the form of anxiety were diagnosed in 32.39% of all the patients, depression in 17.85%, and aggression in 46.15%. The factors determining the level of anxiety in the study group were: sex, age, pain intensity and the lack of pharmacological treatment. Depression was determined by sex, pain intensity and the time of treatment in the clinic, while aggression by age and pain intensity.


Author(s):  
Dariusz Kosson ◽  
Marcin Kołacz ◽  
Robert Gałązkowski ◽  
Patryk Rzońca ◽  
Barbara Lisowska

The aim of the study was to analyze the effect of the treatment given to patients in a pain clinic on their assessment of pain intensity and the incidence of emotional disturbances in the form of anxiety, depression, and aggression. The study was conducted from January 2014 to April 2018 among patients under the care of two Warsaw pain clinics. The study tools were the Hospital Anxiety and Depression Scale—Modified Version (HADS-M) and the Numerical Rating Scale (NRS). The project enrolled 325 patients, with women comprising 60.62% of patients, and the age bracked of 65–79 years comprising 39.38% of patient. The major reasons for attending the pain clinic were osteoarticular pain (44.92%) and neuropathic pain (42.77%). The therapy applied lowered the patients’ pain intensity (4.98 vs. 3.83), anxiety (8.71 vs. 8.12), aggression (3.30 vs. 3.08), and the overall HADS-M score (18.93 vs. 17.90), which shows that the treatment of both the pain symptoms and the associated emotional disturbances in the form of anxiety and aggression was effective. Sex is a factor affecting pain intensity. The level of mental disorders was influenced by the sex and age of the patients and how long they had been treated in the pain clinics.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yasushi Motoyama ◽  
Yoshitetsu Oshiro ◽  
Yumiko Takao ◽  
Hitoaki Sato ◽  
Norihiko Obata ◽  
...  

Abstract Ketamine has been used to treat chronic pain; however, it is still unknown as to what types of chronic pain is ketamine effective against. To identify the effect of administration of subanesthetic-dose ketamine in patients with chronic pain and to clarify the mechanism of the effect, we retrospectively investigated brain functional connectivity using resting-state functional magnetic resonance imaging (rs-fMRI). Patients were divided into responders (Group R: ≥50% improvement on Numerical Rating Scale) and non-responders (Group NR). We compared the differences in terms of brain functional connectivity by seed-to-voxel correlation analysis. Two-sample t-test revealed significant lower connectivity between the medial prefrontal cortex (mPFC) and precuneus in Group R. We also found a significant negative correlation between the improvement rate and functional connectivity strength between the mPFC and precuneus. These findings suggest that subanesthetic-dose ketamine is effective in patients with chronic pain whose brain functional connectivity between the mPFC and precuneus is low. We believe that the current study explored for the first time the correlation between brain functional connectivity and the effect of subanesthetic-dose ketamine for chronic pain and indicated the possibility of use of the predictive marker in pharmacological treatment of chronic pain.


2016 ◽  
Vol 11 (4) ◽  
pp. 1208-1213 ◽  
Author(s):  
Omer A. Raheem ◽  
Sunil H. Patel ◽  
David Sisul ◽  
Tim J. Furnish ◽  
Tung-Chin Hsieh

Chronic opioid therapy for pain management is known to induce several endocrine changes. The authors examined the effect of testosterone supplemental therapy (TST) in patients with chronic, noncancer pain undergoing opioid therapy. It was hypothesized that treatment of opioid-induced hypogonadism (OIH) can reduce opioid requirements in patients suffering from chronic pain and approve their quality of life. Over 18 months period, patients with OIH were identified in a tertiary referral pain center, Numerical Rating Scale (NRS) pain scores and daily morphine equivalent dose (MED) were the primary outcomes measured. Data were collected and comparative analysis performed between men undergoing TST versus nontreatment group. Twenty-seven OIH patients (total testosterone <300 ng/dL) were identified during the study period. TST group consists of 11 patients, while non-TST group consists of 16 patients as control cohort. Mean patient age (55 and 54.4, p = .4) and basic metabolic index (28.5 and 31.9, p = .07) in TST and non-TST groups, respectively. Mean follow-up total testosterone (ng/dL) was significantly higher after TST compared with the non-TST group (497.5 vs. 242.4 ng/dL, p = .03). Median follow-up NRS was 0 and 2 in the TST and non-TST groups ( p = .02). Mean MED (mg) decreased by 21 mg in TST group and increased by 2.5 mg in non-TST group ( p < .05). This study reports that treatment of OIH with TST can reduce opioid requirements in men with chronic pain as quantified by MED. It also confirms previous reports on the potential effects of OIH and that TST is effective in correcting opioid-induced endocrine abnormalities.


Author(s):  
Zahra Abbas Ali Madadi ◽  
Jalil Azimian ◽  
Farzaneh Falahatpishe ◽  
Mahmoud Alipour Heidari

Background: Pain and stress of hemodialysis are experienced by more than 50% of patients who are suffering from renal disease; hence decreasing a part of these adverse effects can be effective on individual’s long term coping with hemodialysis. The current study was done to determine the effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients.Methods: This clinical trial was conducted on 31 hemodialysis patients in 2014. The patients were selected by simple random sampling method and placed in one group. First, the pain intensity of all patients was measured in the six frequent hemodialysis sessions without any intervention (control method). After two weeks, the intervention of warm footbath with vibration was done on all patients and the pain intensity was measured for six frequent hemodialysis sessions (intervention method). The patients were received 40±2 °C footbath with vibration by foot massage spa machine for ten minutes; then, fistula needles were placed and the pain intensity was assessed by using a numerical rating scale. Data were analyzed by ANOVA and T test.Results: The study group had contained 20 males (64.5%), 11 females (35.5%), with an average age of 44.16±14.85 and a range of 18 to 65 years old, which shows that the pain intensity of the warm footbath with vibration method was lower than the control method (P< 0.05).Conclusions: Warm footbath with vibration can be used as an effective palliative method to reduce pain of hemodialysis patients.


2020 ◽  
Vol 24 (3) ◽  
pp. 197-201
Author(s):  
Sanaz Sha'abani ◽  
◽  
Sasan Gazerani ◽  
Maryam Ragheb ◽  
Amir-Hossein Mirgalou-Bayat ◽  
...  

Introduction: Pain is an unpleasant sensory and emotional experience. Evidence suggests a role for microglia in chronic pain and inhibition of microglia leads to decrease of chronic pain intensity in animal models. Minocycline, a semisynthetic tetracycline derivative, is a selective inhibitor of microglia. Several studies have shown pain intensity improvement by minocycline in animal model of pain, but a few studies showed effectiveness on chronic pain improvement in humans. This prospective, self-controlled clinical trial investigated whether minocycline is effective for chronic pain management. Methods: Twenty-two patients, between the ages of 20 and 80 years with radicular lumbar pain with a numerical rating scale >4, who were unresponsive to other medications and had pain duration of >6 weeks were included in the trial. Results: Pain intensity, neuropathic pain and life quality scores assessed before and after treatment. All scores showed significant improvement after 2 weeks of treatment: 56%, 74% and 14%, respectively. Conclusion: Findings of this study suggest minocycline can effectively improve patients’ pain scores and quality of life, even in those with long-term duration of chronic pain and warrants further study.


2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Izumi Makino ◽  
Young-Chang Arai ◽  
Shuichi Aono ◽  
Masayuki Inoue ◽  
Hiroki Sakurai ◽  
...  

Objective. To retrospectively analyze the effects of our original combination therapy treatment on patients with nonodontogenic persistent dentoalveolar pain. Methods. Twenty-one patients suffering from persistent dentoalveolar pain (nineteen females and two males; mean age ± standard deviation: 55.7 ± 19.6 years) participated in this study. They were treated with a therapy combination of jaw exercise and psychoeducation to reduce oral parafunctional activities every month. The intensity of pain in these subjects was evaluated using a numerical rating scale (NRS) before and after treatment. Results. The NRSs at the baseline ranged from 5 to 10 (median, 8), from 0 to 10 (median, 2) at one month after treatment, from 0 to 10 (median, 1) at three months after treatment, and from 0 to 10 (median, 0) at the end of treatment. Pain intensity after treatment improved significantly. Conclusion. There was a significant reduction in pain after our combination of therapies as nonpharmacological treatments, and therefore this treatment could be useful in the management of NPDP patients.


2015 ◽  
Vol 31 (3) ◽  
pp. 229-234 ◽  
Author(s):  
Elena Castarlenas ◽  
Elisabet Sánchez-Rodríguez ◽  
Rocío de la Vega ◽  
Roman Roset ◽  
Jordi Miró

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