title: Assessing pain and mood in a poorly resourced country in a post-conflict setting.
abstract: BACKGROUND
  Accurate pain assessment is important but presents problems in poorly resourced countries. A civil war in Sierra Leone resulted in civilian casualties with pain from deliberate amputation and other injuries.
  
  
  OBJECTIVE
  To examine the quality of simple pain and mood scales.
  
  
  METHODS
  Within a pain treatment project, pain was assessed using numerical and verbal descriptor scales, and mood using visual analogue and verbal descriptor scales. The relationships between these scales (translated where necessary) were examined by comparison of pairs of measures.
  
  
  RESULTS
  The overwhelming majority (99%) used the scales consistently. The verbal pain scale showed substantial discrimination between the pain words mild/small, moderate/half and half, and severe/serious (F=41.80, P<0.001). Numerical and verbal pain scales were related at a modest level (Kendall's tau-b=0.39, P<0.001, n=272) and not dependent on the level of education. A smaller sample (n=30) provided pain data across three assessment occasions, and both pain scales appeared sensitive to change. The 5-point verbal mood scale collapsed into three categories, with reasonable distinction between mood words (F=14.75, P<0.001). The visual analogue scale proved difficult to explain to civilian casualties in this setting.
  
  
  CONCLUSIONS
  Verbal pain and mood scales and numerical pain scales appeared to yield useful information in a post-conflict situation. This suggests that adapting these established rating scales for pain, and for mood, was useful to clinicians and acceptable to patients.
authors: Research Department of Clinical, Educational and Health Psychology, University College London, London, UK. amanda.williams@ucl.ac.uk
authors: Amanda C
authors: AC
authors: de C Williams
authors: Minha
authors: M
authors: Rajput-Ray
authors: Xavier
authors: X
authors: Lassalle
authors: Iain
authors: I
authors: Crombie
authors: Philippe
authors: P
authors: Lacoux
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods*; D012807:Sierra Leone; D014857:Warfare