The measurement of leg ulcer pain: identification and appraisal of pain assessment tools.
OBJECTIVE
To identify and compare the psychometric, clinical sensibility, and pain-specific properties of leg ulcer pain assessment tools for use as a guide for clinicians and researchers.


METHODS
Pain assessment tools were selected for appraisal based on 4 inclusion criteria: (1) designed specifically to measure either quality and/or intensity of pain, (2) used in at least 2 different diseases and/or pain-inducing interventions in adults, (3) generic, and (4) patient self-reporting. The tools were appraised against psychometric properties, clinical sensibility attributes, and pain-specific issues. Two reviewers independently reviewed each abstract, with a third reviewer resolving any disagreements. Then the first 2 reviewers independently assessed the selected tools using the predetermined appraisal criteria.


RESULTS
Of 54 identified pain assessment tools, 5 (the pain ruler, the numerical rating scale, the visual analogue scale, the verbal descriptor scale, and the short-form McGill Pain Questionnaire) met the inclusion criteria. Each tool met the appraisal criteria to varying degrees.


CONCLUSIONS
The use of a pain assessment tool to measure leg ulcer pain is recommended. Clinicians must decide independently which factors are most important when selecting a tool. Although a specific pain assessment approach cannot yet be recommended, a 2-step pain assessment process is most practical. To optimize pain management, further study is needed to ensure that leg ulcer pain is accurately and reliably assessed.
Thrombosis/Hemostasis Research Group, The Ottawa Hospital, Ottawa, Ontario, Canada.
Kathleen A
KA
Nemeth
Ian D
ID
Graham
Margaret B
MB
Harrison
D006801:Humans; D007871:Leg Ulcer / Q000503:physiopathology*; D010147:Pain Measurement / Q000379:methods*