Morrison R S, Ahronheim J C, Morrison G R, Darling E, Baskin S A, Morris J, Choi C, Meier D E
Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York, USA.
J Pain Symptom Manage. 1998 Feb;15(2):91-101.
To determine whether reliable and valid rankings of pain and discomfort resulting from hospital procedures encountered by advanced dementia patients could be developed from interviews with cognitively intact adults, rankings of pain and discomfort resulting from 16 common procedures were obtained from two samples of hospitalized, nondemented adults using ten- (N = 100) and five- (N = 35) point numeric rating scales (NRS). Reliability was assessed by having 30 additional subjects complete ten-point NRS representing the ten most frequent procedures in a re-arranged order. By repeated measure analysis of variance, the scales discriminated between procedures (F = 35.1, P < 0.001). Subjects could discriminate between pain and discomfort (F = 21.6, P < 0.001). The five-point NRS exhibited better subject discrimination between experiences. Reliability was also acceptable. A five-point NRS produced reliable and valid pain and discomfort rankings for 16 common hospital procedures and experiences. These rankings should prove useful in reducing suffering and can serve as surrogates for quantifying pain and discomfort in dementia patients.
为了确定能否通过对认知功能正常的成年人进行访谈，得出晚期痴呆患者在接受医院诊疗操作时产生的疼痛和不适的可靠且有效的排名，我们使用十点（N = 100）和五点（N = 35）数字评定量表（NRS），从两个住院的非痴呆成年人样本中获取了16种常见操作所导致的疼痛和不适的排名。通过让另外30名受试者以重新排列的顺序完成代表十种最常见操作的十点NRS来评估信度。通过重复测量方差分析，这些量表能够区分不同的操作（F = 35.1，P < 0.001）。受试者能够区分疼痛和不适（F = 21.6，P < 0.001）。五点NRS在不同体验之间表现出更好的受试者区分度。信度也是可以接受的。五点NRS为16种常见的医院操作和体验产生了可靠且有效的疼痛和不适排名。这些排名应有助于减轻痛苦，并可作为量化痴呆患者疼痛和不适的替代指标。
