Jensen Mark P, Turner Judith A, Romano Joan M
Department of Rehabilitation Medicine (RJ-30), University of Washington School of Medicine, Seattle, WA 98195 USA Department of Multidisciplinary Pain Center (RC-95), University of Washington School of Medicine, Seattle, WA 98195 USA Department of Psychiatry and Behavioral Sciences (RP-10), University of Washington School of Medicine, Seattle, WA 98195 USA.
Pain. 1994 Sep;58(3):387-392. doi: 10.1016/0304-3959(94)90133-3.
An important issue that has yet to be resolved in pain measurement literature concerns the number of levels needed to assess self-reported pain intensity. An examination of treatment outcome literature shows a large variation in the number of levels used, from as few as 4 (e.g., 4-point Verbal Rating scales (VRS)) to as many as 101 (e.g., 101-point Numerical Rating scales (NRS)). The purpose of this study was to provide an empirically derived guideline for determining the number of levels needed. Chronic pain patients (n = 124) provided pre- and post-treatment measures of pain intensity using 101-point NRS for least, most, current, and average pain. The patients' responses to the measures were examined closely to determine the actual number of levels used. In addition, their responses to the 101-point scales were recorded to form 7 scales of varying levels (2- to 101-point scales). The sensitivity of the 7 recorded scales was examined. The results indicated that little information is lost if 101-point scales are coded as 11- or 21-point scales. Moreover, examination of the actual responses to the 101-point measure showed that almost all patients treated it as a 21-point scale by providing responses in multiples of 5 or 10, while a substantial number of patients treated it as an 11-point scale, providing responses in multiples of 10 only. The results suggest that 10- and 21-point scales provide sufficient levels of discrimination, in general, for chronic pain patients to describe pain intensity.
疼痛测量文献中一个尚未解决的重要问题涉及评估自我报告的疼痛强度所需的等级数量。对治疗结果文献的研究表明，所使用的等级数量差异很大，少至4个等级（例如，4点言语评定量表（VRS）），多至101个等级（例如，101点数字评定量表（NRS））。本研究的目的是提供一个基于实证得出的确定所需等级数量的指南。慢性疼痛患者（n = 124）使用101点NRS对最轻、最重、当前和平均疼痛进行治疗前和治疗后的疼痛强度测量。仔细检查患者对这些测量的反应，以确定实际使用的等级数量。此外，记录他们对101点量表的反应，以形成7个不同等级的量表（2点至101点量表）。检查这7个记录量表的敏感性。结果表明，如果将101点量表编码为11点或21点量表，几乎不会丢失信息。此外，对101点测量的实际反应检查表明，几乎所有患者将其视为21点量表，以5或10的倍数提供反应，而相当多的患者将其视为11点量表，仅以10的倍数提供反应。结果表明，一般来说，10点和21点量表为慢性疼痛患者描述疼痛强度提供了足够的区分度。
