NOTE: The scale references the work of Keefe et al on pain behaviors.
Observable pain behaviors:
(1) facial grimacing
(2) holding or supporting affected body part or area
(3) limping or distorted gait
(4) frequent shifting of posture or position
(5) extremely slow movements
(6) sitting with a rigid posture
(7) moving in a guarded or protective fashion
(8) moaning
(9) using a cane, cervical collar or other device
(10) stooping while walking
(11) other
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Original Grading
|
Points
|
|
pain behaviors exaggerated and/or nonphysiologic
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- 10
|
|
pain behaviors are mixed or ambiguous
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0
|
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pain behaviors are appropriate and tend to confirm other physical findings
|
+ 10
|
where:
• The scores represent a continuum from –10 to +10. A given behavior can be scored between these 2 limits.
• Visual analogue scales could be used for data capture.
• In the implementation I have used a 7 point Likert scale.
total score =
= SUM(points for responses)
Interpretation:
• minimum score: -100 (for 10 items, -110 for 11 items)
• maximum score: 100 (for 10 items, 110 for 11 items)
• The higher the score the more appropriate the pain behavior. The lower the score the more suspect the behavior.
Limitations:
• Most of the assessments are subjective. Inter-rater and test-retest measures are likely to show some variation.
• Masking when scores cancel would be an issue in some patients.
