User:Jalyn547/Pain scale

A pain scale measures a patient's pain intensity or other features. Pain scales are a common communication tool in medical contexts, and are used in a variety of medical settings. Pain scales are a necessity to assist with better assessment of pain and patient screening. Pain measurements help determine the severity, type, and duration of the pain, and are used to make an accurate diagnosis, determine a treatment plan, and evaluate the effectiveness of treatment.^{[medical citation needed]} Pain scales are based on trust, cartoons (behavioral), or imaginary data, and are available for neonates, infants, children, adolescents, adults, seniors, and persons whose communication is impaired. Pain assessments are often regarded as "the 5th vital sign".

What is Pain?

Pain is a complex experience with both sensory and emotional elements that typically indicates a potential issue in your nervous system. It alerts you to potential injuries and medical conditions that may require medical assistance. The sensation of pain is an unpleasant or discomforting feeling that can manifest as sensations such as pricking, tingling, burning, stinging, shooting, aching, or electric. Pain can vary in intensity, from very mild to very severe; duration, short-lived to chronic; and location, one localized area or all over the body.^[1]

There are three different types of pain based on the duration of the sensations: acute, episodic, and chronic. The most common are acute and chronic. Acute pain occurs suddenly, is sharp, and goes away once the issue is treated. Acute pain is caused by things like broken bones, childbirth, strained muscles, or burns.^[2] Episodic pain occurs irregularly from time to time. It may be caused by underlying medical conditions or it can come out of nowhere.^[2] Chronic pain is pain that is consistent for at least 3 months. Acute pain can become chronic, however, there usually is no known cause for chronic pain. Chronic pain can have negative effects on relationships, daily living, work, extracurricular activities, etc.^[2]

The experience of pain is extremely unique for an individual, as all people feel pain differently. As a result of this, self-reporting is the best and most common practice for describing pain to medical personnel.^[2]

History of Pain Scales

The practice of measuring pain has been a topic in research since the late 1800s. There were many methods used for assessing the intensity of pain, in humans as well as animals, using electrical, mechanical, and heat stimuli. Over time these methods have evolved, however, there were limitations to these historical methods. The limitations were in addressing the dimensions of pain duration, modality, locus, and response type. The main focus at the time was on acute pain rather than chronic pain. Researchers and Clinicians are more interested in information on chronic pain due to its longevity. The locus of pain also differs between clinical and experimental settings; clinical pain is usually deeper while experimental pain is superficial. Furthermore, the response type to pain can contribute to further challenges for interpretation in both preclinical and clinical research.^[2][3]

The Dolorimeter, created in 1940 at Cornell University, was one of the first methods used to gather information on pain threshold and tolerance. The instrument applied steady pressure, heat, or electrical stimuli to measure sensations of pain. Beecher was one of the first to suggest something other than the dolorimeter; he suggested that clinical pain be measured by its relief using subjective ratings. Numerical rating scales (NRS), verbal rating scales(VRS), and visual analog scales (VAS) on a 10-cm continuum are the scales used to attain these ratings. Melzack and Torgerson developed the McGill Pain Questionnaire which rates pain quantitatively by sensory, evaluative, and affective descriptors. These are things like burning, shooting, and agonizing.^[3]

There have been many methods developed that use observational techniques where pain is evaluated by others. Such a method, for example, is the FLACC scale. It is for young children who are too young to be able to tell anyone how they feel. It measures facial expressions, leg position, activity, crying, and concealability on a 0-2 scale. ^[3]

Pain Assessment

There are many different instruments used to assess both the intensity of pain as well as the effect of pain. A few are listed below:

The Numeric Rating Scale (NRS-11) is an 11-point scale for patient self-reporting of pain. It is based solely on the ability to perform activities of daily living (ADLs) and can be used for adults and children 10 years old or older.

Pain interferes with a person's ability to perform ADLs. Pain also interferes with a person's ability to concentrate, and to think. A sufficiently strong pain can be disabling on a person's concentration and coherent thought, even though it is not strong enough to prevent that person's performance of ADLs. However, there is no system available for measuring concentration and thought.

Verbal Rating Scale

The verbal rating scale is a pain measurement tool that uses adjectives to express various levels of pain. The scale is rated in a similar way as no pain at all to the most extreme pain ever felt. When doing clinical trials there is usually a four-to six-point VRS. There are a few limitations to this scale. Some people might find it hard to accurately express their pain with the limited number of options to choose from. Interpretation of the options is also a potential issue, as people could interpret them all differently.

Visual Analog Scale

The visual analog scale is a visual scale that has two endpoints: “no pain” and “pain is as bad as it could be”. When it was first created people had to physically write their answers on the scale. There are mechanical ones now to make the scoring of them easier.

I want to remove this section on Endometriosis. I see no point in having it. It seems randomly thrown in, doesn't seem fully complete, and I feel like you can't talk about one painful condition without talking about all of them. Why was this specific medical condition special? Why endometriosis and not cancer? So, because of these reasons, I feel it would be best to just remove this section altogether. I believe removing this section will make the article more clear and concise.

The most common pain scale for quantification of endometriosis-related pain is the visual analogue scale (VAS). A review came to the conclusion that VAS and numerical rating scale (NRS) were the best adapted pain scales for pain measurement in endometriosis. For research purposes, and for more detailed pain measurement in clinical practice, the review suggested use of VAS or NRS for each type of typical pain related to endometriosis (dysmenorrhea, deep dyspareunia and non-menstrual chronic pelvic pain), combined with the clinical global impression (CGI) and a quality of life scale.

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Instructor Feedback

While I can see where you brought over a block of text from the original article, no changes or edits have been proposed. When you make those proposed changes, be sure to put them in a distinctive font (e.g., bold, italics, or underline). I do notice grammatical errors in the text above that you could improve as well as a location that requires a citation.

I see the edit you have made but without sources, it will likely be removed from the platform when you propose the change. What literature (peer-reviewed secondary) can you provide to back up the claims made here? I would highly encourage you to reach out to Katie for help finding sources if you need it!

Peer Review Responses

Professor Rhan: I have a couple other sources but I will reach out to Katie. For the paragraph I wrote I did use one of the sources already used in the article because I noticed that they didn't really use it much.

Nicolemicha: I planned to make the paragraph I wrote part of the Lead. I also used one of the sources that was already listed because they didn't use much from it. Once I add more, I do think it could be a good article, as it already has decent bones.

Kmcmiche: The sentence I deleted probably was good, I deleted it because it didn't have a source as part of the "make a small edit" assignment. A lot of the information in this article is not cited, so, it will be a tedious process trying to find which source the information came from and then adding it to the text that is already there. I will make sure all of my contributions have cited sources that are good and reliable.

MPHILLI: I forgot to add the source to the bibliography section, however I do have the source. It was actually one already used, that I felt wasn't used very thoroughly. I definitely plan to add more sections to this article because it is lacking a bit. The suggested sections would be a great touch. For the endometriosis section, I wanted to ask why it was put in the article in the first place. That section, to me, seems a bit out of the blue.