Herr K A, Mobily P R, Kohout F J, Wagenaar D
College of Nursing, The University of Iowa, Iowa City 52242, USA.
Clin J Pain. 1998 Mar;14(1):29-38. doi: 10.1097/00002508-199803000-00005.
The specific objective for this research was to determine initial psychometric properties of the Faces Pain Scale (FPS) as a measure of pain intensity for use with the elderly.
The study was descriptive correlational in nature, with nonrandom sampling. A total sample of 168 community subjects (30-121, depending on task completed), aged 65 or older, participated in the research protocol. To determine the validity, reliability, and scaling properties of the FPS, rating and ranking procedures, placement tasks, and test-retest methods were used.
Response to six Likert-type items indicated that subjects agreed that the FPS represents pain: however, it is clear that the perception of the meaning of the faces can be influenced by the context in which they are presented. Rank ordering tasks for the individual faces demonstrated near-perfect agreement between the actual expected ranking and the ranking produced by the subjects (Kendall's W = .97, p = .00). When subjects placed individual faces along a 1-m-long red wedge indicating the amount of pain represented by each face, statistically significant separation of the faces in the anticipated equal interval position was demonstrated by the lack of overlap of the 95% confidence intervals when all faces were viewed and positioned simultaneously. However, when subjects placed faces independent of others, the expected placement fell outside the 95% confidence limit for three of the five faces placed. In addition, the actual intervals between the five faces placed by subjects demonstrated substantial variances from the 167 mm expected in several instances. Rating a vividly remembered painful experience about the degree of pain perceived using the FPS initially and again 2 weeks later, the FPS demonstrated strong reproducibility over time with a Spearman rho correlation coefficient of .94 (p = .01).
These results provide preliminary support for the construct validity, strong ordinal properties, and strong test-retest reliability of the FPS with a sample of elderly individuals. The equality of intervals in the FPS has not been fully supported in the older adult, but given the complexity of the task used, the results should not be considered to be refuted. Further evaluation of the FPS with experimental and clinical pain conditions and comparison with other standard pain assessment instruments in the elderly population are warranted.
本研究的具体目的是确定面部疼痛量表（FPS）作为一种用于老年人疼痛强度测量工具的初始心理测量特性。
本研究本质上是描述性相关性研究，采用非随机抽样。共有168名65岁及以上的社区受试者（根据完成的任务不同，年龄在30 - 121岁之间）参与了研究方案。为了确定FPS的有效性、可靠性和量表特性，采用了评分和排序程序、放置任务以及重测方法。
对六个李克特式项目的回答表明，受试者认同FPS能够代表疼痛：然而，很明显对面部含义的认知会受到呈现面部的背景影响。对单个面部的排序任务显示，实际预期排序与受试者产生的排序之间几乎完全一致（肯德尔和谐系数W = 0.97，p = 0.00）。当受试者沿着一条1米长的红色楔形线放置单个面部以表明每个面部所代表的疼痛程度时，当同时查看和放置所有面部时，95%置信区间缺乏重叠，表明面部在预期的等距位置上有统计学上的显著分离。然而，当受试者独立于其他面部放置时，在放置的五个面部中有三个的预期放置位置落在了95%置信区间之外。此外，受试者放置的五个面部之间的实际间隔在几个实例中与预期的167毫米有很大差异。最初使用FPS对一段生动回忆起的痛苦经历的疼痛程度进行评分，并在2周后再次评分，结果显示FPS随时间具有很强的可重复性，斯皮尔曼等级相关系数为0.94（p = 0.01）。
这些结果为FPS在老年人群样本中的结构效度、强顺序特性和强重测可靠性提供了初步支持。FPS中等距性在老年人中尚未得到充分支持，但考虑到所使用任务的复杂性，这些结果不应被视为被反驳。有必要在实验性和临床疼痛条件下对FPS进行进一步评估，并与老年人群中的其他标准疼痛评估工具进行比较。
