Two methods of assessing pain intensity in English-speaking and Spanish-speaking emergency department patients

Introduction Each year emergency departments see millions of patients' many with moderate to severe pain. The use of valid, language-sensitive pain assessment methods is a critical prerequisite to selection and evaluation of pain treatment interventions. However, scant research has been conducted on the validity of pain intensity measurements in English-speaking and non-English-speaking ED patients. This study validated two measures of pain intensity—a 0 to 10 numerical rating scale (NRS) and a word descriptor scale (WDS)—in English-speaking and Spanish-speaking ED patients and determined patient preferences for the pain rating scales. Methods ED patients with various medical conditions were asked to rate their pain intensity using both scales, in their language, seven times during a 2-hour study period. Patients were then asked to choose the pain scale that they preferred to use. Results Moderate to strong correlations were found between the NRS and WDS pain scales. In addition, the NRS and WDS were equally preferred by patients, whether they spoke English ( n = 95) or Spanish ( n = 21). Discussion We demonstrated in this study that both the NRS and the WDS scales were valid instruments for measuring pain in English-speaking and Spanish-speaking ED patients. In addition, very little difference was found in patient preference for one of the scales. ED patients in acute pain were able to use both ways of communicating their pain to health professionals. Therefore patients could be offered their choice of either of these simple pain rating scales to evaluate pain and the effectiveness of pain-relieving interventions.