Related Experiment Video
Updated: Aug 11, 2026
A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
Published on: January 18, 2018
Influencing Factors and Stability of Self-reported and Observational Pain Scales in Poststroke Patients: A
Wan-Jung Wu1, Man-Hua Yang1, Kuan-Chia Lin2
1College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Purpose:
This study aimed to identify factors influencing poststroke pain and evaluate the stability of self-reported and observational pain scales to support nurses in selecting and using pain assessment tools more accurately.
Design:
A cross-sectional study.
Methods:
A total of 122 patients with stroke were recruited from a hospital in northern Taiwan. Pain was assessed using the Numeric Rating Scale (NRS), Faces Pain Scale (FPS), and Pain Assessment in Advanced Dementia (PAINAD). Multiple regression analyses were performed to identify demographic and clinical factors associated with pain scores. Item response theory (IRT) was used to evaluate the stability and measurement performance of the three scales across different levels of pain severity.
Results:
Participants with diabetes or cognitive impairment had significantly higher PAINAD scores, whereas those with a history of stroke had higher NRS scores. Depressive symptoms were associated with higher scores on all three pain scales. The scales demonstrated moderate correlations with one another. IRT analysis showed that the FPS had the highest discrimination across pain levels. In contrast, the PAINAD had the greatest difficulty and may underestimate pain in patients experiencing higher levels of pain.
Conclusion:
Diabetes, prior stroke, cognitive impairment, and depressive symptoms significantly influenced poststroke pain assessment. All three scales were suitable for assessing pain in patients with stroke. The NRS was most appropriate for mild to moderate pain, the FPS for moderate to severe pain, and the PAINAD for a broad range of pain levels.
Clinical Implications:
Nurses should consider patients' clinical characteristics, cognitive function, communication ability, and pain severity when selecting a pain scale. The FPS may be prioritized because of its high discrimination, whereas PAINAD scores should be interpreted cautiously because this scale may underestimate severe pain.
