Painful sensations are always unpleasant. With their frequent occurrence, most patients immediately consult a doctor. However, pain can have not only a different nature, but also an uneven degree of intensity. Currently, there is no device that would most accurately determine the severity of discomfort in a patient. That is why a visual analogue pain scale (YOUR) was developed. With its help, doctors can establish the fact whether the patient is able to endure pain, or if it has an unbearable character. To date, several methods have been developed to determine the intensity of discomfort. But the visual analogue pain scale is still the most informative.
Abbreviation
A method for determining the intensity of discomfort was developed in 1974 by an American scientist. Immediately, the method was widely used in medical practice. It was decided to designate it with the acronym VAS, which stands for Visual Analogue Scale. In Russia, it is customary to use the abbreviation YOUR - visual-analogue scale.
The essence of the method
YOUR is a subjective way of assessing the pain of the patient who is currently experiencing it. For example, in some conditions a person feels one degree of discomfort, in others - another. The most common situation is when the patient experiences increased pain in the affected area at night, and during the day his quality of life remains virtually unchanged.
The VAS Visual Analogue Scale is a way of identifying discomfort at a time when a person is being seen by a doctor. In this situation, the patient should only indicate to the specialist that increased pain intensity occurs, for example, at night or in the evening.
The doctor suggests that the person mark a point on an ungraded line, which, in his opinion, will reflect the severity of discomfort. In this case, the specialist informs the patient that the left border corresponds to the absence of pain, and the right indicates its presence, and it is so unbearable that it is practically incompatible with life.
In practice, a plastic, cardboard or paper ruler is most often used. Its length is 10 cm.
Medical practice
The visual analogue pain scale is rarely used in therapy. For a specialist with a wide profile, in most cases it is enough to know that there are uncomfortable sensations in principle. In addition, it is important for the therapist to know what hours they are worried about and their nature.
The scale for assessing the intensity of pain has been widely used in oncology and anesthesiology. This is due to the fact that in some cases, doctors must receive as soon as possible the most complete information regarding the presence of discomfort without any clues. In recent years, in practice, VAS has also been used by rheumatologists.
Modified scale
It's no secret that colors affect a person in different ways. Doctors, knowing this property, decided to slightly modify the visual-analogue scale. The essence of the method remains the same. The changes affected the line itself. The usual scale is presented in black. The modified one has a line whose color changes from green to red. Doctors are convinced that such a neoplasm will reduce the likelihood of obtaining inaccurate data, since patients at a subconscious level better associate their sensations with flowers.
How is the study
Despite the fact that YOUR is most popular in anesthesiology and oncology, it can be used in any field of medicine. The research algorithm is as follows:
- The doctor examines the patient. Already at this stage, he can assume how much painful person experiences.
- The doctor offers the patient a ruler 10 cm long, on which he must put a point. It is necessary to indicate the site that, according to the researcher, corresponds to the degree of intensity of the pain disturbing him. In this case, it is imperative to take into account that the left side of the line means a complete absence of discomfort, the right side, respectively, its presence.
- Centimeter divisions are applied on the other side of the product. The doctor evaluates the test results, taking into account other nuances. For example, he may ask whether the patient is engaged in physical activity, what are the duration and quality of his sleep. This information provides an opportunity to confirm the validity of the study.
Using a visual analogue scale, the doctor is able to follow the dynamics and evaluate the success of the prescribed treatment. The best option for the development of events is one in which at each subsequent appointment the patient indicates a point closer to the left edge.
Interpretation of Results
As mentioned above, the visual analogue scale for assessing pain is an ungraded 10-centimeter line. It can be standard or modified. The corresponding notes are shown on the reverse side, that is, the patient does not see them during the test.
The interpretation of the results (values and their interpretation) is as follows:
- 0. This is the absence of pain; a person does not feel it at all.
- 1. Uncomfortable sensations are extremely weak. A person practically does not think about them. The presence of mild pain does not affect the quality of life.
- 2. Unpleasant sensations are weakly expressed. But at the same time, the pain is periodically paroxysmal in nature and can sometimes intensify. A person experiencing discomfort is most often irritated.
- 3. Pain bothers regularly, the patient is constantly distracted by it. But at the same time, a person easily gets used to it and is able to carry out any type of activity if it is available.
- 4. Pain of a moderate nature. If the patient is heavily immersed in any activity, he may not notice it for some time. However, the rest of the time she worries him, distracting from her is quite difficult.
- 5. The pain is moderately strong. You can ignore it for a maximum of several minutes. Discomfort is a constant concern. However, if a person makes an effort, he will be able to do some work or take part in a mass event.
- 6. The pain is still moderately severe. But she already greatly interferes with the usual daily activities. It becomes extremely difficult to focus on something.
- 7. The pain is severe. She literally subjugates all the other sensations. In addition, it significantly interferes with communication with other people and the implementation of daily activities. A person does not sleep well at night because of pain.
- 8. The sensations are intense. Physical activity is extremely limited. In order to maintain communication, considerable effort is required.
- 9. The pain is painful. A person is not able to even talk. Sometimes he makes uncontrollable moans.
- 10. The pain is unbearable. The patient is bedridden, he often raves. Pain of this nature is almost incompatible with life.
Based on the results of the study, the doctor can judge not only the intensity of sensations, but also the course of the pathology as a whole.
Error
The specialist must draw conclusions about the patient’s health status, taking into account not only the obtained indicator of the visual-analogue scale. It is necessary to rely on the error. For example, some patients do not feel relief after the therapy, but for some reason do not want to offend the doctor. In this regard, they deliberately reduce the rate of pain.
Some individuals, by contrast, are prone to exaggeration. For example, women may indicate excruciating pain. Moreover, if they are asked about what sensations they experienced during delivery, most of them will indicate pain that is almost incompatible with life. In such situations, it is necessary to reduce the resulting figure by half.
Thus, the doctor should focus not only on YOURS, but also carefully monitor the patient's condition. The most indicative criteria are speech and facial expressions.
Benefits
A doctor, focusing on a visual analogue scale, pain can stop using the most effective means. For example, with weak sensations, the use of non-narcotic drugs, such as Ibuprofen, Paracetamol, Diclofenac, is indicated. If the pain is unbearable, the introduction of the strongest medicines is required. In addition, in many cases, it is advisable to carry out a blockade or alcohol abuse.
Another advantage of the YOUR scale is its simplicity and ease of use. It is indispensable in cases where the doctor needs to find out the severity of pain, and the patient for some reason cannot speak or does it with great difficulty.
disadvantages
The main disadvantage of the visual analogue scale is its one-dimensionality. In other words, a person can only indicate the intensity of the pain.
In addition, the emotional component of the syndrome often leads to an unreliable result. As mentioned above, many patients deliberately underestimate the severity of pain or, conversely, significantly increase it. In such situations, the further development of events depends on the literacy and attentiveness of the doctor.
Finally
Visual analogue scale (VAS) is a simple way to determine the intensity of pain in a patient. It is an ungraded 10-centimeter line. It can be either black or color. The patient points to the line a point that, in his opinion, corresponds to the intensity of the pain. The severity of sensations intensifies from left to right. Based on the test results, the doctor can choose the most suitable drugs and evaluate the dynamics of treatment. In addition, he gets the opportunity to analyze the course of the disease as a whole.