Winkelman Chris, Norman David, Maloni Judith A, Kless Jack R
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.
Appl Nurs Res. 2008 May;21(2):104-9. doi: 10.1016/j.apnr.2006.05.002.
The purpose of this article is to examine the agreement between two measures of pain in laboring women who receive epidural analgesia for relief to support validity and reliability of the Visual Analog Scale (VAS) in this population.
There are several different approaches to measuring pain in laboring women. However, the psychometric properties of pain relief measures in this population are not well established. This investigation examines agreement (i.e., concordance) between the visual analog scale for pain sensation and sensation measured by dermatome level assessment.
Fifty pregnant women in labor who underwent epidural placement recorded their sensation of pain on the VAS simultaneously with the certified nurse anesthetist recording sensation by using a standard dermatome chart after administration of epidural analgesia.
There was moderate, significant correlation between the two measures. However, agreement between the two measures did not meet preset standards with Bland-Altman analysis, suggesting that one measure cannot be substituted for the other. Overall, the average dermatome levels alone underestimated pain in laboring women as recorded by the VAS, although both under-and overestimation of pain relief occurred during the series of observations.
本文旨在研究接受硬膜外镇痛的分娩女性的两种疼痛测量方法之间的一致性，以支持视觉模拟量表（VAS）在该人群中的有效性和可靠性。
测量分娩女性疼痛有几种不同的方法。然而，该人群中疼痛缓解测量方法的心理测量特性尚未得到充分确立。本研究考察了疼痛感觉视觉模拟量表与通过皮节水平评估测量的感觉之间的一致性（即一致性）。
50名接受硬膜外麻醉的分娩孕妇在硬膜外镇痛给药后，在视觉模拟量表上记录她们的疼痛感觉，同时由持照护士麻醉师使用标准皮节图表记录感觉。
两种测量方法之间存在中度显著相关性。然而，通过布兰德-奥特曼分析，两种测量方法之间的一致性未达到预设标准，这表明一种测量方法不能替代另一种。总体而言，仅平均皮节水平低估了视觉模拟量表记录的分娩女性的疼痛，尽管在一系列观察中疼痛缓解既有低估也有高估。
