No Pain

Worst Possible Pain

Thie VAS is a 100-mm line with no pain at one end (0 mm) and worst pain possible at the other end (100 mm). The tool was designed to be used for research where a mark could easily be measured to ascertain the intensity of the pain.

To use the VAS, the nurse asks patients to mark on the line where they feel their pain intensity is best represented. If a patient marks the line at the 50-mm position, the pain would be said to be 5/10 when compared with the NRS, or moderate level pain.

Thie VAS is one of the most basic scales and has some limitations for clinical use.

Limitations include:

■ Some older adult patients have difficulty marking on the line and place the mark above or below the 100-mm line (D'Arcy, 2003; Herr & Garand, 2001; Herr & Mobily, 1993).

■ Reassessment and comparison options are limited.

The Verbal Descriptor Scale (VDS)

The Verbal Descriptor Scale (VDS)

No Pain Mild Pain Moderate Severe Very Severe Worst Possible Pain Pain Pain Pain

The purpose of the verbal descriptor scale is to provide a method for patients to use word descriptors to rate their pain. The scale is anchored on one end with no pain, and the opposite end anchor indicates high-intensity pain and is labeled as worst pain possible. The scale uses words such as mild, moderate, and severe to measure pain intensity. To use the scale, the nurse asks the patient to select the word that best describes the pain they are experiencing. Clinically, some patients prefer to use a word to describe their pain rather than a number. Although the VDS

is normally used for cognitively intact patients, Feldt, Ryden, and Miles (1998) found a 73% completion rate with the VDS in cognitively impaired patients.

Limitations include:

■ Patient must be able to understand the meaning of the words.

■ Reassessment and comparisons are difficult.

Numeric Rating Scale (NRS)

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