Critical Appraisal of Pain Assessment Tools


Patients presenting with acute pain in hospital settings need immediate intervention and care to improve health outcomes (Department of Health Service, 2007). When severe acute pain is not appropriately managed, this could lead to adverse psychological and physiological effects, poorer health outcomes and prolonged hospital stay (ANZCA, 2005). In Australia, approximately a third of patients in hospital settings report experiencing moderate to severe pain at least once during their hospital stay (DHS, 2007). While this figure may vary according to the population surveyed in hospital settings, it is observed that inadequate pain relief is still present in these settings (ANZCA, 2005).

Quality care for patients presenting with acute pain begins with the use of an appropriate pain assessment tool. The main aim of this essay is to critically review current pain assessment tools that are recommended by the Department of Health Services (DHS, 2007). Published primary studies will be used to support the critical analysis. The first part of this essay will compare a range of pain assessment tools for patients presenting with acute pain. The second part critically analyses pain assessment options for patients who are non-verbal, have significant cognitive impairment or language functions disability. A conclusion will then summarise the key issues raised in this essay.

Critical Analysis of Current Pain Assessment Tools

Pain assessment tools range from the use of subjective to objective pain-scoring assessment tools. Examples of subjective-pain scoring tools include the visual analogue scale (VAS), numerical rating scale (NRS) and the faces pain scale (FPS). Objective measures include the behavioural pain assessment scale,functional activity score and Abbey Pain Scale. Currently, VAS is one of the recommended tools for assessing acute pain in different groups of patients (DHS, 2007). Recent studies (Phan et al., 2012; Angthong, Cherchugit, Suntharapa, & Harnroongroj, 2011; Boonstra, SchiphorstPreuper, Reneman, Posthumus, & Stewart, 2008) have also shown its validity and reliability for different health conditions across different groups of patients and in various health care settings outside Australia. Apart from extensive published data on the reliability and validity of the VAS, it is also shown to be more sensitive when compared to descriptive pain scales (Boonstra et al., 2008).

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