Interpreting the Meaning of Pain Severity Scores

Abstract

Poor pain management practices are generally discussed in terms of barriers associated with the patient, clinician and/or health care organization. The impact of deficiencies in the tools that are used to measure pain are seldom addressed. Three factors are discussed that complicate the measurement of pain: the nature of pain, the lack of meaning associated with scores generated by pain scales, and treatment goals that lack specificity and are not linked to patients' pain scores. The major premise presented in the present article is that the utility of pain measurement is limited because health care professionals do not have a common understanding of the meaning of scores generated by pain measurement tools, especially within the acute care setting. To address this issue, approaches to establishing instrument validity need to be broadened to include the examination of the meaning and consequences of these measurements within a specific context. Substantive improvements in pain management are unlikely to occur until criteria are identified to link explicitly the scores generated by pain measurement tools to treatment goals.

Nursing judgement and decision‐making using the Sedation Withdrawal Score (SWS) in children

“…This variation in decision-making in the face of identical information mirrors other studies involving nurses and pain assessment (Hodgins 2002), nurses and critical event risk assessment (Thompson et al 2009) and triage assessments made by emergency nurses Cioffi (1998). These findings support the view that clinical judgements are influenced more by what nurses bring to the situation than by the clinical data available to them (Tanner 2006).…”

Orthodontic pain trajectories in adolescents: Between-subject and within-subject variability in pain perception

“…It is generally believed that healthcare professionals lack a common understanding of the meanings behind the scores that pain assessment tools generate, especially in acute care settings. 25 In our study, results show that there are statistically significant and clinically meaningful individual differences in both the average profile of pain perception and in day-today fluctuations around individuals' own trends. Therefore, the common practice of evaluating orthodontic pain by using a single measure obtained on each day can prove misleading; and clinicians managing orthodontic pain should identify such differences as they emerge, and treat patients accordingly.…”

Women's Recovery from Sternotomy-Extension (WREST-E) study: examining long-term pain and discomfort following sternotomy and their predictors

“…We observed that pain and discomfort scores were positively skewed in the WREST Trial,20 thus we dichotomised these scores. A score of ⩾3/10 indicated some-moderate pain and ⩽2/10 indicated no pain 20 23 24. We followed the same procedure for WREST-E analyses.…”