Cut-off points for mild, moderate and severe pain on the numeric rating scale for pain in patients with chronic musculoskeletal pain: variability and influence of sex and catastrophizing.

Frontiers in Psychology

Albère J.A. Koke¹  René F.A. Oosterwijk²  Roy E. Stewart³  Jeannette L. Swaan⁴  Anne M. Boonstra⁵  Karlein M.G. Schreurs⁶  Henrica R. Schiphorst Preuper⁷ 

[1] Occupational Medicine, University Medical Centre Groningen, University of Groningen;Adelante Centre of Expertise in Rehabilitation and Audiology;;Community &MGG Medical Centre Alkmaar and Gemini Hospital Den Helder;Revalidatie Friesland;Rijndam Rehabilitation Institute;;Roessingh Research &

关键词: Chronic Pain;    Classification;    Musculoskeletal Pain;    Numeric rating scale;    Pain interference;   

DOI  :  10.3389/fpsyg.2016.01466

来源: DOAJ

【 摘 要 】

Objectives. The 0 – 10 Numeric Rating Scale (NRS) is often used in pain management. The aims ofour study were to determine the cut-off points for mild, moderate and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the variability of the optimal cut-off points, and to determine the influence of patients’ catastrophizing and their sex on these cut-off points. Methods. 2854 patients were included.Pain was assessed by the NRS, functioning by the Pain Disability Index (PDI) and catastrophizing by the Pain Catastrophizing Scale (PCS). Cut-off point schemes were tested using ANOVAs with and without using the PSC scores or sex as co-variates and with the interaction between CP scheme and PCS score and sex, respectively. The variability of the optimal cut-off point schemes was quantified usingbootstrapping procedure. Results and conclusion. The study showed that NRS scores ≤5 correspond to mild, scores of 6-7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning. Bootstrapping analysis identified this optimal NRS cut-off point scheme in 90 % of the bootstrapping samples. The interpretation of the NRS is independent of sex, but seems to depend on catastrophizing. In patients with high catastrophizing tendency, the optimal cut-off point scheme equals that for the total study sample, but in patients with a low catastrophizing tendency, NRS scores ≤3 correspond to mild, scores of 4-6to moderate and scores ≥7 to severe pain in terms ofinterference with functioning. In these optimal cut-off schemes, NRS scores of 4 and 5 correspond to moderate interference with functioning for patients with low catastrophizing tendency and to mild interference for patients with high catastrophizing tendency. Theoretically one would therefore expect that among the patients with NRS scores 4 and 5 there would be a higher average PDI score for those with low catastrophizing than for those with high catastrophizing. However, we found the opposite. The fact that we did not find the same optimal CP scheme in the subgroups with lower and higher catastrophizing tendency may be due to chance variability.

【 授权许可】

Unknown