Volume 44 Number 2 2007
Pages 305 — 314

Abstract - Determining mild, moderate, and severe pain equivalency across pain-intensity tools in nursing home residents

Katherine R. Jones, RN, PhD, FAAN;1 Carol P. Vojir, PhD;1 Evelyn Hutt, MD;2* Regina Fink, RN, PhD, FAAN3

1School of Nursing, University of Colorado at Denver and the Health Sciences Center, Denver, CO; 2Denver Department of Veterans Affairs Medical Center, Research Enhancement Award Program; School of Medicine, University of Colorado at Denver and the Health Sciences Center, Denver, CO; 3University of Colorado Hospital, Denver, CO

Abstract — Older adults in nursing homes experience pain that is often underassessed and undertreated. Visual analog pain-intensity scales, recommended for widespread use in adults, do not work well in the older adult population. A variety of other tools are in use, including the Verbal Descriptor Scale, the Faces Pain Scale (FPS), and the Numeric Rating Scale. These tools are more acceptable to older adults, but no agreement exists about how to compare the resulting pain-intensity scores across residents. This study examined the equivalency of pain-intensity scores for 135 nursing home residents who reported their pain on the three different instruments. The results were validated with a second sample of 135 nursing home residents. The pain levels across the three tools were highly correlated, but residents were found to underrate higher pain intensity on the FPS. A modification of scoring for the FPS led to greater agreement across the three tools. The findings have implications for use of these tools for quality improvement and public reporting of pain.

Key words: dementia, elderly, Faces Pain Scale, Numeric Rating Scale, nursing homes, pain assessment, pain intensity, pain-intensity tools, pain-level equivalency, rehabilitation.

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