Chang Hsien-Chen, Lai Yeur-Hur, Lin Kuan-Chia, Lee Tzu-Ying, Lin Hung-Ru
Author Affiliations: Department of Nursing, Chi Mei Medical Center, Tainan (Ms Chang); and School of Nursing, National Taiwan University, Taipei (Dr Lai); and Institute of Hospital and Health Care Administration, National Yang Ming University, Taipei (Dr K.-C. Lin) and School of Nursing (Drs Lee and H.-R. Lin), National Taipei University of Nursing and Health Sciences, Taiwan.
Cancer Nurs. 2017 Jul/Aug;40(4):269-275. doi: 10.1097/NCC.0000000000000410.
Effective pain management requires careful assessment of pain. Auditory, visual, cognitive, and motor impairments in elderly people may affect their ability to use pain assessment tools.
The aim of this study was to evaluate the reliability, validity, and no-response rate of pain scales among elderly patients with cancer pain, as well as patient preference for the scales.
A cross-sectional correlational design was used with a convenience sample of 73 elderly cancer patients recruited at a cancer-based hospital in southern Taiwan. Participants were asked to rate their pain by using a numeric rating scale (NRS-11), a facial pain scale (FPS), a verbal descriptor scale (VDS), and a mixed scale (consisting of NRS-11, FPS, and VDS) on 2 consecutive days.
Test-retest reliability, as indicated by Spearman rank correlation coefficients for the 24-hour interval pain ratings, ranged from 0.426 to 0.683. The criterion-related validity of the scales was supported by significant Spearman rank-order correlation. The time taken to respond to the scales ranged from 40.3 to 16.2 seconds. The no-response rates for the scales decreased in the order NRS-11 > FPS > mixed scale > VDS. Patient preference for the scales decreased in the order mixed scale > VDS > NRS-11 > FPS.
All 4 scales were reliable and valid for assessing cancer pain among elderly patients.
Because the no-response rates for the scales depended on educational level and cognitive function, nurses should exercise good judgment in choosing pain intensity assessment tools for use with elderly patients.
有效的疼痛管理需要对疼痛进行仔细评估。老年人的听觉、视觉、认知和运动障碍可能会影响他们使用疼痛评估工具的能力。
本研究旨在评估老年癌症疼痛患者疼痛量表的信度、效度和无反应率，以及患者对这些量表的偏好。
采用横断面相关性设计，以便利抽样的方式选取了台湾南部一家癌症专科医院的73例老年癌症患者。要求参与者在连续两天使用数字评定量表（NRS-11）、面部疼痛量表（FPS）、语言描述量表（VDS）和混合量表（由NRS-11、FPS和VDS组成）对自己的疼痛进行评分。
24小时间隔疼痛评分的Spearman等级相关系数表明，重测信度范围为0.426至0.683。量表的效标关联效度得到了显著的Spearman等级相关的支持。对量表做出反应所需的时间范围为40.3至16.2秒。量表的无反应率从高到低依次为NRS-11＞FPS＞混合量表＞VDS。患者对量表的偏好从高到低依次为混合量表＞VDS＞NRS-11＞FPS。
所有4种量表在评估老年患者癌症疼痛方面都是可靠且有效的。
由于量表的无反应率取决于教育水平和认知功能，护士在为老年患者选择疼痛强度评估工具时应谨慎判断。
