Phase 2 Assessment of a New Functional Pain Scale by Comparing It to Traditional Pain Scales

Background Assessment of pain has always been subjective and is commonly assessed using a numeric pain scale (NPS) or Wong-Baker faces scale. The pain intensity score is not standardized and relies on individuals’ past experiences. The disadvantage of using such pain assessment scales and treating the numbers can lead to overdosing on analgesics leading to unwanted side effects. The Robert Packer Hospital/Functional Pain Scale (RPH/FPS) was developed as a tool for the objective assessment of pain and its impact on a patient’s function. Aim The study aimed to validate the RPH/FPS scale against NPS and Wong-Baker faces scale in medical, surgical, and trauma patients. The patients’ were also asked to rank the scales as one (1) being the most preferred to three (3) being the least preferred. Design This prospective, observational cohort study compares the two most common pain scales, the NPS and the Wong-Baker Faces, to the RPH/FPS. Methods Spearman correlation was used to test for correlation between the three scales, and Wilcoxon rank-sum test was used to compare means between the RPH/FPS and NPS. The study participants were also asked to rate their preferences for the scales by rating the most preferred of the three scales as one (1) and the least preferred number three (3). Results The RPH/FPS had a strong correlation with both the NPS and Wong-Baker Faces scales (RPH/FPS vs. NPS R=0.69, p<0.001: RPH-FPS vs. Wong-Baker Faces R=0.69, P<0.001). As for preferences, the RPH/FPS was ranked first on 36.9% of the surveys followed by NPS on 35.9%, and the Wong-Baker Faces on 22.3%. There were 4.9% of the surveys missing the preference rankings. Conclusion The results validate the RPH/FPS scale against the NPS and Wong-Baker Faces scales. This gives the clinicians a tool for objective assessment of pain and its effect on the recovery process, thereby minimizing the observed disconnect that sometimes happens between the reported pain intensity level and the providers' observation of the patient.

[1]  Adeolu Adeboye,et al.  Assessment of Functional Pain Score by Comparing to Traditional Pain Scores , 2021, Cureus.

[2]  S. Dobscha,et al.  Limitations of pain numeric rating scale scores collected during usual care: Need for enhanced assessment , 2018 .

[3]  Terri Bickert,et al.  Improving patients' pain experience in a large rural hospital. , 2017, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[4]  Jonathan Evans,et al.  Do No Harm … Whatever That Means , 2016 .

[5]  Roger Chou,et al.  Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. , 2016, The journal of pain : official journal of the American Pain Society.

[6]  Linda S. Franck,et al.  A Debate on the Proposition that Self-report is the Gold Standard in Assessment of Pediatric Pain Intensity , 2015, The Clinical journal of pain.

[7]  J. Farrar,et al.  Are Pain Ratings Irrelevant? , 2015, Pain medicine.

[8]  C. Pasero.  One size does not fit all: opioid dose range orders. , 2014, Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses.

[9]  D. Weiner,et al.  Pain as the fifth vital sign: exposing the vital need for pain education. , 2013, Clinical therapeutics.

[10]  C. L. Baeyer.  What's the score in pain assessment? , 2012 .

[11]  C. V. von Baeyer,et al.  What's the score in pain assessment? , 2012, The Medical journal of Australia.

[12]  Mark P. Jensen,et al.  Validity of four pain intensity rating scales , 2011, PAIN®.

[13]  A. Ledgerwood,et al.  Kindness kills: the negative impact of pain as the fifth vital sign. , 2007, Journal of the American College of Surgeons.

[14]  H. Kehlet,et al.  Improving pain management: are we jumping from the frying pan into the fire? , 2007, Anesthesia and analgesia.

[15]  R. Soto,et al.  The Efficacy and Safety of Pain Management Before and After Implementation of Hospital-Wide Pain Management Standards: Is Patient Safety Compromised by Treatment Based Solely on Numerical Pain Ratings? , 2005, Anesthesia and analgesia.

[16]  S. Fishman,et al.  The use of 'as-needed' range orders for opioid analgesics in the management of acute pain: a consensus statement of the American Society for Pain Management Nursing and the American Pain Society. , 2005, Home healthcare nurse.

[17]  William D. Dupont,et al.  Power and sample size calculations. A review and computer program. , 1990, Controlled clinical trials.

[18]  M. Halm,et al.  Pilot Evaluation of a Functional Pain Assessment Scale , 2019, Clinical nurse specialist CNS.

[19]  D. Topham,et al.  Quality Improvement Project: Replacing the Numeric Rating Scale with a Clinically Aligned Pain Assessment (CAPA) Tool. , 2017, Pain management nursing : official journal of the American Society of Pain Management Nurses.

[20]  B. Taira,et al.  Validation of the Wong-Baker FACES Pain Rating Scale in pediatric emergency department patients. , 2010, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[21]  Barbara St. Marie Anp Gnp.  Pain Assessment and Pharmacologic Management , 2010 .

[22]  Lester W.Burket,et al.  Burket's oral medicine: Diagnosis and treatment , 1977 .