Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands.
Res Dev Disabil. 2013 Oct;34(10):3442-8. doi: 10.1016/j.ridd.2013.07.016. Epub 2013 Aug 6.
People with intellectual disabilities are at high risk for pain and have communication difficulties. Facial and numeric scales for self-report may aid pain identification. It was examined whether the comprehension of a facial affective scale and a numeric scale for pain in adults with Down syndrome (DS) varies with presentation format. Adults with DS were included (N=106, mild to severe ID, mean age 37 years), both with (N=57) and without (N=49) physical conditions that may cause pain or discomfort. The Facial Affect Scale (FAS) and a numeric rating scale (NRS) were compared. One subgroup of participants (N=50) had to choose the two items within each format to indicate 'least pain' and 'most pain'. The other subgroup of participants (N=56) had to order three faces of the FAS from 'least pain' to 'most pain', and to answer questions about the magnitude of numbers for the NRS. Comprehension percentages were compared between two subgroups. More participants understood the FAS than the NRS, irrespective of the presentation format. The comprehension percentage for the FAS did not differ between the least-most extremities format and the ordering/magnitude format. In contrast, comprehension percentages for the NRS differed significantly between the least-most extremities format (61%) and the ordering/magnitude format (32%). The inclusion of ordering and magnitude in a presentation format is essential to assess thorough comprehension of facial and numeric scales for self-reported pain. The use of this format does not influence the number of adults with DS who pass the comprehension test for the FAS, but reduces the number of adults with DS who pass the comprehension test for the NRS.
智障人士患疼痛的风险较高，且存在沟通困难。面部表情量表和数字评分量表可能有助于识别疼痛。本研究旨在考察唐氏综合征（Down syndrome，DS）成人对用于自我报告疼痛的面部情感量表和数字评分量表的理解是否会因呈现方式而有所不同。研究纳入了 DS 成人（N=106，轻度至重度智力障碍，平均年龄 37 岁），包括（N=57）和不包括（N=49）可能引起疼痛或不适的身体状况。对面部表情量表（Facial Affect Scale，FAS）和数字评分量表（Numeric Rating Scale，NRS）进行了比较。参与者的一个亚组（N=50）必须从每种格式中选择两个项目来表示“最不痛”和“最痛”。另一个亚组（N=56）必须对 FAS 的三张面孔进行从“最不痛”到“最痛”的排序，并回答有关 NRS 数字大小的问题。比较了两个亚组的理解百分比。无论呈现格式如何，理解 FAS 的参与者都多于理解 NRS 的参与者。最痛-最不痛格式和排序/大小格式的 FAS 理解百分比无差异。相比之下，NRS 的理解百分比在最痛-最不痛格式（61%）和排序/大小格式（32%）之间存在显著差异。呈现格式中包含排序和大小对于评估自我报告疼痛的面部和数字量表的全面理解至关重要。使用这种格式不会影响通过 FAS 理解测试的 DS 成人的数量，但会减少通过 NRS 理解测试的 DS 成人的数量。
