A COMPARISON OF THE HOPKINS PAIN RATING INSTRUMENT WITH STANDARD VISUAL ANALOG AND VERBAL DESCRIPTOR SCALES IN PATIENTS WITH CANCER PAIN

A self-contained, portable, pain rating instrument that provides an immediate result for documentation PurPoses was developed to improve pain assessment in cancer patients. The Hopkins Pain Rating Instrument (HPRI) is a 5 x 20 cm plastic visual analogue scale (VAS) with a sliding marker that moves within a groove that measures 10 cm. The side facing the patient resembles a traditional VAS while the opposite side is marked in cm to quantify pain intensity. This psychometric study, which employed a descriptive correlational design, evaluated the reliability and validity of the HPRI by comparing it with a traditional VAS and verbal descriptor scale (VDS). Outpatients with and without pain and inpatients with pain rated their major pain site with the three instruments, which were presented in random order. This was followed by a mental status exam and re-rating of pain with the same instruments to assess test-retest reliability. Completing the study were 71 patients with a variety of cancers and a mean age of 52.8 years. Of these patients, 68% had pain and 54% were receiving opioid analgesics. The most common pain sites were the back, leg, and epigastric areas. On initial and repeat testing, there were high correlations between the HPRI and the VAS (r = 0. 99, P < 0.0001) and the VDS (r = 0.85, P < 0.0001). The correlation coefficients for test-retest reliability for the HPRI, VAS, and VDS were 0. 9 7, 0.9 7, and 0. 9 4 (P < 0.001). The HPRI appears to be a reliable and valid tool to measure pain intensity. It should facilitate the documentation of cancer pain and the monitoring of pain relief interventions, thereby improving patient care.