Single Dimension Surveys

The VAS consists of a straight 100-mm line with the words "no pain" at the left-most end and "worst pain imaginable" at the right-most end (Fig. 5.2). Patients are instructed to mark on the line the amount of pain they feel at the current time. By measuring the distance from the left-most end of the line to the patient's mark, a numeric representation of the patient's pain

No Pain Figure 5.2 Visual analog scale.

can be determined. This simple survey method makes the VAS highly effective because of its ease of use as well as its understandability.

The NRS lists the numbers 0-10, with "no pain" at the left-most end and "worst pain imaginable" at the right-most end (Fig. 5.3). With the NRS, patients are instructed to circle the number that best represents the amount of pain they are currently experiencing. However, the disadvantage of both the NRS and VAS scales lies in their attempt to assign a numerical value to a complex, multifactorial process. Both tests have a ceiling for the worst pain experienced, which limits a patient's ability to convey a worsening of his/her pain if that patient marks his/her pain as being the worst pain imaginable on initial evaluation.

0

1

2

3

4

S

6

7

8

9

Figure 5.3 Numerical rating scale.

Worst Pain Imaginable

Because children have more difficulty in quantifying their level of pain, assessment tools like the Wong-Baker FACES scale (Fig. 5.4) and the Faces Pain Scale provide a reliable and easily understood survey for children. The main disadvantage posed by these surveys is their inability to be used in children under the age of 3.

Figure 5.4 Wong-Baker FACES scale.
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