Lege Artis Medicinae

[Options for assessing the quality of postoperative pain relief: unidimensional scales]

LOVASI Orsolya1, LÁM Judit2, LÉBER Andrea3, GAÁL Péter2

FEBRUARY 24, 2022

Lege Artis Medicinae - 2022;32(01-02)

DOI: https://doi.org/10.33616/lam.32.004

Journal Article

[The measurement of the quality of postoperative pain relief receives increasing attention in clinical practice since the not properly treated pain has several negative consequences for both the patients and the health care providers. An important component of the evaluation of the quality of care is the measurement of patient outcomes, which needs regular pain assessments and reliable pain assessment tools. The main goal of our paper is to review the literature on scales and pain assessment tools for postoperative pain assessment, the systematic literature search of which was performed by the PICO (population, intervention, control, and outcomes) technique. We found 396 accessible and evaluable articles in total, and out of them we summarized the results of the most important 31 in English and 3 in Hungarian. Organisations in the field of pain relief recommend the regular assessment of postoperative pain by unidimensional and multidimensional scales. Among unidimen­sional scales, we compared the Numerical Rating Scale (NRS), the Visual Analogue Scale (VAS) and the Verbal Descriptor Scale (VDS) with one another by discussing their advantages and limitations in measuring the intensity of postoperative pain. Al­though in clinical practice NRS is the most widely used one, VAS is more sensitive in the detection of changes and the best for statistical analysis. The advantage of VDS is that no significant differences can be detected in the interpretation of its results. At the same time, the application of VAS is the most difficult and the least preferred by patients and not always applicable immediately after the operation. The VDS is the least sensitive measurement tool, whose results are influenced by differences of the patients’ verbal interpretation, thus it is not applicable among patients with a weak vocabulary. In general, the main advantage of unidimensional scales is that they are fast and easy to use, but they measure only one dimension of pain, namely its intensity, and the association between the in­tensity ratings, the patients' subjective ex­perience of pain and its observable consequences are not unequivocal in certain cases. Consequently, when the circumstances permit, the use of multidimensional measurement tools should be considered.]

AFFILIATIONS

  1. Semmelweis Egyetem, Dr. Rácz Károly Doktori Iskola
  2. Semmelweis Egyetem, Egészségügyi Menedzserképző Központ
  3. Dombóvári Szent Lukács Kórház

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