An application of pain rating scales in geriatric patients

This study examined the applicability of three different pain rating scales , the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS) and the N umeric Rating Scale (NRS), in geriatric patients. Data collection was perfo rmed in a geriatric clinic at a university hospital. A structured interview was conducted with 167 patients (mean age=80.5 years). Patients rated thei r current experience of pain twice with a 5-minute pause in-between on the VAS, GRS and NRS, and were then asked if they experienced pain, ache or hur t (PAH) or other symptoms. The correlations were high and significant both between the ratings of the VAS, GRS and NRS (r=0.78-0.92; p<0.001) (alterna tive-forms reliability), and between the test and retesting (r=0.75 - r=0.8 3; p<0.001) (test-retest reliability). A logistic regression analysis showe d that the probability to accomplish a rating on the pain scales decreased with advancing age of the patient, and this was especially marked for the V AS. The probability of agreement between the patients' ratings of pain and the verbal report of PAH tended to decrease with advancing age; this was es pecially so for the VAS. Patients who verbally denied PAH but reported pain on the scales rated it significant lower (p<0.001) than those who verbally reported PAH and rated the pain as well. Eighteen percent of patients who denied pain but rated a pain experience verbally expressed suffering or dis tress. The study suggests that pain rating scales such as the VAS, GRS and NRS can be used to evaluate pain experience in geriatric patients. However, agreement between verbally expressed experience of PAH, and the rated expe rience of pain tended to decrease with advancing age. This indicates that t he pain-evaluating process will be substantially improved by an additional penetration supported by a wide variety of expression of hurt, ache, pain, discomfort and distress. (C)2000, Editrice Kurtis.