Evaluation of Pain Intensity Assessment Tools Among Elderly Patients With Cancer in Taiwan
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Hsien-Chen Chang1, Yeur-Hur Lai, Kuan-Chia Lin
1Author Affiliations: Department of Nursing, Chi Mei Medical Center, Tainan (Ms Chang); and School of Nursing, National Taiwan University, Taipei (Dr Lai); and Institute of Hospital and Health Care Administration, National Yang Ming University, Taipei (Dr K.-C. Lin) and School of Nursing (Drs Lee and H.-R. Lin), National Taipei University of Nursing and Health Sciences, Taiwan.
Background:
Effective pain management requires careful assessment of pain. Auditory, visual, cognitive, and motor impairments in elderly people may affect their ability to use pain assessment tools.
Objective:
The aim of this study was to evaluate the reliability, validity, and no-response rate of pain scales among elderly patients with cancer pain, as well as patient preference for the scales.
Methods:
A cross-sectional correlational design was used with a convenience sample of 73 elderly cancer patients recruited at a cancer-based hospital in southern Taiwan. Participants were asked to rate their pain by using a numeric rating scale (NRS-11), a facial pain scale (FPS), a verbal descriptor scale (VDS), and a mixed scale (consisting of NRS-11, FPS, and VDS) on 2 consecutive days.
Results:
Test-retest reliability, as indicated by Spearman rank correlation coefficients for the 24-hour interval pain ratings, ranged from 0.426 to 0.683. The criterion-related validity of the scales was supported by significant Spearman rank-order correlation. The time taken to respond to the scales ranged from 40.3 to 16.2 seconds. The no-response rates for the scales decreased in the order NRS-11 > FPS > mixed scale > VDS. Patient preference for the scales decreased in the order mixed scale > VDS > NRS-11 > FPS.
Conclusions:
All 4 scales were reliable and valid for assessing cancer pain among elderly patients.
Implications For Practice:
Because the no-response rates for the scales depended on educational level and cognitive function, nurses should exercise good judgment in choosing pain intensity assessment tools for use with elderly patients.
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