Validation of three pain scales among adult postoperative patients in Ghana.

Lydia Aziato,Kissinger Marfo,Florence Dedey,James Avoka Asamani,Joe Nat A Clegg-Lamptey

doi:10.1186/s12912-015-0094-6

Lydia Aziato, Kissinger Marfo + Show 3 more

Open Access

https://doi.org/10.1186/s12912-015-0094-6

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Abstract

BackgroundPain assessment is an important component of pain management and health professionals require valid tools to assess pain to guide their pain management decisions. The study sought to select, develop, and validate context-appropriate unidimensional pain scales for pain assessment among adult post-operative patients.MethodsA mixed methods design was adopted. The study was conducted at two hospitals in Accra, Ghana. The qualitative phase involved 17 patients and 25 nurses, and the quantitative phase involved 150 post-operative patients. Qualitative data was collected iteratively through individual interviews and focus groups.ResultsTwo existing pain scales (0–10 Numeric Rating Scale [NRS] and Wong-Baker FACES [FPS] scales) and one new pain scale (Colour-Circle Pain Scale–[CCPS]) were validated. The psychometric properties of the three scales were assessed when patients had fully recovered from anesthesia. The CCPS had higher scale preference than NRS and FPS. Convergent validity was very good and significant (0.70–0.75). Inter-rater reliability was high (0.923–0.928) and all the scales were sensitive to change in the intensity or level of pain experienced before and after analgesia such as paracetamol and diclofenac suppositories, injectable pethidine, and oral tramadol had been administered.ConclusionUsing a valid tool for pain assessment gives the clinician an objective criterion for pain management. Due to the subjective nature of pain, consideration of socio-cultural factors for the particular context ensures that the appropriate tool is used.

Highlights

Pain assessment is an important component of pain management and health professionals require valid tools to assess pain to guide their pain management decisions
The results of this study are presented in two sections; Section One presents the tool development process and Section Two reports the psychometric properties findings
The 5 male and 20 female nurses who were involved in the pain scale development were between 26 and 50 years of age and had 6 to 15 years experience in surgical nursing

Summary

Introduction

Pain assessment is an important component of pain management and health professionals require valid tools to assess pain to guide their pain management decisions. The study sought to select, develop, and validate context-appropriate unidimensional pain scales for pain assessment among adult post-operative patients. Context-appropriate pain assessment tools are necessary for different groups of people. The lack of appreciation of a people’s culture could result in the use of pain assessment tools and techniques that are ineffective and culturally inappropriate [4]. Appropriate pain assessment tools should be identified for specific cultural groups to ensure accurate pain assessment and management because every patient has the right to effective pain management [1]. Assessing pain in a culturally competent manner decreases health care disparity.

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