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Validation of a faces pain scale in postsurgical geriatric patients
Arturo García-Galicia1, Irandy Guzmán-Maya2, Álvaro J Montiel-Jarquín3
1Departamento, Unidad Médica de Alta Especialidad Hospital de Especialidades de Puebla, Centro Médico Nacional "Gral. de Div. Manuel Ávila Camacho", Instituto Mexicano del Seguro Social (IMSS), Estado.
Antecedentes:
Los pacientes geriátricos presentan dificultad progresiva para expresar el dolor. Es muy importante establecer un parámetro preciso para manejar el dolor posoperatorio.
Objetivo:
Determinar la validez de la escala facial del dolor (EFD) en pacientes geriátricos posquirúrgicos.
MéTodo:
Estudio comparativo, observacional, prolectivo, en un hospital de segundo nivel de atención. Fase 1: se presentaron las caras de la escala desordenadas a personas ≥ 60 años, con Glasgow íntegro, previa firma de consentimiento, para ordenarlas ascendentemente. Fase 2: se incluyeron pacientes ≥ 60 años, de cualquier sexo, sometidos a cualquier procedimiento quirúrgico, con Glasgow íntegro, previa firma de consentimiento informado. Se eliminaron los que no cooperaron o no completaron ambas escalas. A cada paciente se aplicó, antes de recibir analgesia, la escala visual numérica (EVN), y 5 minutos después la EFD, y nuevamente 30 minutos tras la analgesia. Se utilizó estadística descriptiva, tamaño del efecto, t pareada y Spearman.
Resultados:
Fase 1: todas las caras fueron ubicadas correctamente (75-100%). Fase 2: participaron 142 pacientes, 76 (53.5%) hombres y 66 (46.5%) mujeres. Promedios preanalgesia: EFD 3.4, EVN 7.9; posanalgesia: EFD 1.8, EVN 4.8. Tamaño del efecto (EFD): 2.389; t pareada 17.231 (p < 0.002); Spearman 0.654 (p = 0.016) preanalgesia, 0.798 (p = 0.004) posanalgesia.
ConclusióN:
La EFD es válida para evaluar la intensidad del dolor posoperatorio en pacientes geriátricos.
Background:
Geriatric patients present progressive difficult to assess pain. Getting a precise parameter to approach postsurgical pain is a very important issue.
Objective:
To explore Faces Pain Scale (EFD) validity in geriatric post-surgical patients.
Method:
Comparative, observational, prolective study in patients from a second level attention unit. Phase 1: faces were disorderly presented to ≥ 60 years old persons, Glasgow scale scored 15, signed authorization, to place them in ascending order. Phase 2: ≥ 60 years old patients, any sex, who received any surgical procedure, Glasgow scale scored 15, signed authorization were recruited. Those who did not cooperate/complete scales application were eliminated. Numeral Visual Scale (EVN) and 5 minutes after EFD were applied to each patient, before analgesia, and again 30 minutes after analgesia. Descriptive statistical data, effect-size, Student paired-t and Spearman tests were used.
Results:
Phase 1: every face was correctly placed (75-100%). Phase 2: 142 patients participated, 76 (53.5%) male, 66 (46.5%) female. Pre-analgesia media scores: EFDA 3.4, EVN 7.9; post-analgesia media scores: EFD 1.8, EVN 4.8. EFD effect-size test scored 2.389, paired-t scored 17.231 (p < 0.002); Spearman scores: 0.654 (p = 0.016) pre-analgesia, 0.798 (p = 0.004) post-analgesia.
Conclusion:
EFD is a valid scale to evaluate postoperative pain intensity in geriatric patients.
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