School of Health and Welfare, Jönköping University, Jönköping, Sweden.
Department of Anesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
J Clin Nurs. 2019 Mar;28(5-6):959-968. doi: 10.1111/jocn.14705. Epub 2018 Nov 8.
To validate the Numeric Rating Scale (NRS) for postoperative nausea assessments, and determine whether a central tendency, median, based on patients' self-rated nausea is a clinically applicable daily measure to describe patients' nausea after major surgery.
Postoperative nausea causes major discomfort, risks for complications and prolonged hospital stays. The NRS is recommended for the assessment of pain but is little explored for assessing nausea.
A repeated measure design was carried out on patients who had undergone major surgery in three Swedish hospitals.
Nonparametric statistical methods were used to analyse (a) associations between the NRS and a verbal scale (no, mild, moderate and severe) and (b) to analyse associations between Measure 1 (nausea scores postoperative Day 1) and Measure 2 (retrospective nausea scores at rest and during activity, postoperative Day 2). Reporting of this research adheres to the Strobe Guidelines.
The mean age of the 479 patients (44% women) in the sample was 65 years (range, 22-93 years). Self-assessed nausea scores from the NRS and the verbal scale correlated well (r = 0.79). Correlation between nausea at rest and nausea during activity was r = 0.81. The calculated median scores (Measure 1) showed only moderate correlations with retrospective nausea scores (Measure 2); 4-9 ratings, r = 0.41; 6-9 ratings, r = 0.54.
Numeric Rating Scale scores showed strong associations with a verbal scale; therefore, the NRS seems to be a valid tool to measure nausea intensity. The quality of daily summarised median nausea scores needs to be further explored before clinical use.
The use of the NRS in assessments of nausea in postoperative care will facilitate communication between patients and health care professionals regarding nausea intensity. When documenting nausea, it seems unnecessary to distinguish nausea at rest from nausea during activity.
验证数字评分量表（NRS）用于术后恶心评估，并确定基于患者自我评估的恶心的中位数是否是描述大手术后患者恶心的一种临床适用的日常测量方法。
术后恶心会引起严重不适，增加并发症风险和延长住院时间。NRS 推荐用于疼痛评估，但很少用于评估恶心。
在瑞典的三家医院对接受大手术的患者进行了重复测量设计。
使用非参数统计方法分析（a）NRS 与口头量表（无、轻度、中度和重度）之间的关联，以及（b）分析第 1 测量值（术后第 1 天恶心评分）与第 2 测量值（术后第 2 天静息时和活动时的回顾性恶心评分）之间的关联。本研究报告符合 Strobe 指南。
样本中 479 名患者（44%为女性）的平均年龄为 65 岁（范围 22-93 岁）。NRS 和口头量表的自我评估恶心评分相关性良好（r=0.79）。静息时恶心与活动时恶心之间的相关性为 r=0.81。计算得出的中位数评分（第 1 测量值）与回顾性恶心评分（第 2 测量值）仅中度相关；4-9 级评分，r=0.41；6-9 级评分，r=0.54。
NRS 评分与口头量表具有很强的关联；因此，NRS 似乎是测量恶心强度的有效工具。在临床应用之前，还需要进一步探讨日常总结中位数恶心评分的质量。
在术后护理中使用 NRS 评估恶心将促进患者和医护人员之间关于恶心强度的沟通。在记录恶心时，似乎没有必要区分静息时的恶心和活动时的恶心。
