From the Guidelines
The 0-10 Numeric Rating Scale (NRS) is the most valid and feasible pain scale for assessing pain intensity in adult patients who can communicate reliably, as it has the highest rate of success and is most highly favored by patients 1. When evaluating pain in critically ill adults, it is essential to use a self-report scale that is easy to understand and use. The 0-10 NRS, either verbal or visual, is a valid and feasible option, as it has been shown to have the highest rate of success and is most highly favored by ICU patients 1. Some key points to consider when using the 0-10 NRS include:
- The scale should be administered either verbally or visually to accommodate different patient needs and preferences.
- The 0-10 NRS has been shown to have the best sensitivity, negative predictive value, and accuracy compared to other self-report scales, such as the Visual Analog Scale (VAS) and the Verbal Descriptor Scale (VDS) 1.
- Patients have reported that the 0-10 NRS is easy to use and useful in identifying pain intensity, making it a valuable tool for healthcare providers to track pain progression and evaluate treatment effectiveness.
- For patients who are unable to use a numerically formatted scale, a descriptive pain scale like the VDS should be considered as an alternative 1.
From the Research
Overview of Pain Scales
- Pain scales are essential tools for assessing and managing pain in patients, as they provide a standardized way to measure pain intensity and impact on daily life 2.
- There are various types of pain scales, including numeric rating scales, verbal rating scales, and visual analogue scales, each with its strengths and limitations 3.
Types of Pain Scales
- Numeric Rating Scale (NRS): a widely used scale that asks patients to rate their pain from 0 to 10, with 0 indicating no pain and 10 indicating severe pain 4, 5.
- Verbal Rating Scale (VRS): a scale that uses words to describe pain intensity, such as "mild", "moderate", or "severe" 3.
- Visual Analogue Scale (VAS): a scale that uses a continuous scale to measure pain intensity, often with a range of 0 to 100 mm 3.
- Faces Pain Scale-Revised (FPS-R): a scale that uses facial expressions to measure pain intensity in children 6.
Validation and Reliability of Pain Scales
- Studies have shown that pain scales are valid and reliable tools for assessing pain, but they can be subjective and influenced by individual patient factors 4, 5.
- The NRS has been shown to be moderately associated with research-administered measures of pain intensity, but less associated with measures of pain-related function, mental health, and health-related quality of life 5.
- The FPS-R has been shown to be equally effective and reliable as the Verbal Numerical Rating Scale (vNRS) in assessing pain in children 6.
Clinical Use of Pain Scales
- Pain scales are essential tools for clinicians to assess and manage pain in patients, and to monitor the effectiveness of treatments 2, 3.
- Clinicians should be aware of the potential limitations and biases of pain scales and use them in conjunction with other assessment tools to get a comprehensive understanding of a patient's pain experience 3.