Pain Measurement in Older Adults with Head and Neck Cancer and Communication Impairments

The ability to communicate the presence of pain by means of verbal and nonverbal communication is crucial to facilitate the assessment of pain. Patients with communication impairment (CI) are limited in their ability to verbally report their pain and, consequently, mechanisms to elicit information about the pain experience must incorporate simple and valid methods to accomplish this goal. Pain measurement and the impact of the pain experience in older adults with CI are areas that have been studied on a limited basis in nursing. This study compared the effectiveness of 3 pain assessment tools in measuring pain intensity in the older adults with head and neck cancer and with CI. Multivariate repeated-measures analysis of variance revealed that there were no significant differences in the mean pain intensity scores when subjects used the Numeric Rating Scale, the Faces Pain Scale, and the Visual Analogue Scale at 3 different time intervals. The highest correlation coefficients between pain measurement tools were identified during the third time when the pain measurement tools were used to rate pain intensity. Subjects identified the Numeric Rating Scale as the preferred method to rate pain intensity. Canonical correlation analysis demonstrated that among the demographic variables evaluated in the study, education explained the largest variance in composite of the pain measurement scales.