title: The visual analogue thermometer and the graphic numeric rating scale: a comparison of self-report instruments for pain measurement in adults with burns.
abstract: To evaluate the adequacy of pain management in burn care, pain measurement is essential. The visual analogue thermometer (VAT) and graphic numeric rating scale (GNRS) are frequently used self-report instruments for burn pain. To legitimise their interchangeable use in research and practice, we aimed to compare self-reports obtained by the VAT and GNRS, the ability of the scales to differentiate background from procedural pain, and to compare potential cutpoints. Adults with acute burns (N=319) participated in the study (67% male, mean age 40.3 years (SD 16), mean TBSA 9.9% (SD 10.4). Correlation coefficients between VAT and GNRS were 0.64 and 0.55 for, respectively, morning and afternoon background pain and 0.51 for procedural pain (p<0.01). VAT scores were lower than GNRS scores for all pain types (p<0.01). Both scales could differentiate background from procedural pain: procedural pain was higher (p<0.01). The standardized response mean was moderate (0.518 for VAT and 0.571 for GNRS). Self-reported thresholds for 'unacceptable pain' by GNRS were higher than by VAT (p<0.001). ROC analyses showed that the highest sensitivity was reached for pain score 2 for both scales. The results suggest that the instruments cannot be used interchangeably without taking their differences into account.
authors.affiliation: Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands; Association of Dutch Burn Centres, Beverwijk, The Netherlands. Electronic address: aeedejong@rkz.nl.
authors.forename: A E E
authors.initials: AE
authors.lastname: de Jong
authors.affiliation: Association of Dutch Burn Centres, Beverwijk, The Netherlands; Burn Centre, Martini Hospital, Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Bremer
authors.affiliation: Association of Dutch Burn Centres, Beverwijk, The Netherlands; Burn Centre, Maasstad Hospital, Rotterdam, The Netherlands.
authors.forename: H W C
authors.initials: HW
authors.lastname: Hofland
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Schuurmans
authors.affiliation: Association of Dutch Burn Centres, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Middelkoop
authors.affiliation: Association of Dutch Burn Centres, Beverwijk, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
authors.forename: N E E
authors.initials: NE
authors.lastname: van Loey
mesh_terms: D000328:Adult; D002056:Burns / Q000150:complications* / Q000628:therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000517:prevention & control; D010147:Pain Measurement / Q000295:instrumentation* / Q000379:methods; D012372:ROC Curve; D057566:Self Report / Q000592:standards; D012680:Sensitivity and Specificity
keywords: Adults; Burns; Cutpoints; Measurement; Nursing; Pain; Self-report