EVALUATION OF THE FACES PAIN SCALE FOR USE WITH THE ELDERLY

Objective: The specific objective for this research was to determine i nitial psychometric properties of the Faces Pain Scale (FPS) as a meas ure of pain intensity for use with the elderly. Design: The study was descriptive correlational in nature, with nonrandom sampling. A total sample of 168 community subjects (30-121, depending on task completed) , aged 65 or older, participated in the research protocol. To determin e the validity, reliability, and scaling properties of the FPS, rating and ranking procedures, placement tasks, and test-retest methods were used. Results: Response to six Likert-type items indicated that subje cts agreed that the FPS represents pain; however, it is clear that the perception of the meaning of the faces can be influenced by the conte xt in which they are presented. Rank ordering tasks for the individual faces demonstrated near-perfect agreement between the actual expected ranking and the ranking produced by the subjects (Kendall's W =.97, p =.00). When subjects placed individual faces along a I-m-long red wed ge indicating the amount of pain represented by each face, statistical ly significant separation of the faces in the anticipated equal interv al position was demonstrated by the lack of overlap of the 95% confide nce intervals when all faces were viewed and positioned simultaneously . However, when subjects placed faces independent of others, the expec ted placement fell outside the 95% confidence limit for three of the f ive faces placed. In addition, the actual intervals between the five f aces placed by subjects demonstrated substantial variances from the 16 7 mm expected in several instances. Rating a vividly remembered painfu l experience about the degree of pain perceived using the FPS initiall y and again 2 weeks later, the FPS demonstrated strong reproducibility over time with a Spearman rho correlation coefficient of .94 (p =.01) . Conclusion: These results provide preliminary support for the constr uct validity, strong ordinal properties, and strong test-retest reliab ility of the FPS with a sample of elderly indivuduals. The equality of intervals in the FPS has not been fully supported in the older adult, but given the complexity of the task used, the results should not be considered to be refuted. Further evaluation of the FPS with experimen tal and clinical pain conditions and comparison with other standard pa in assessment instruments in the elderly population are warranted.