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Preliminary Validation of the Defense and Veterans Pain Rating Scale (DVPRS) in a Military Population

Authors

  • Chester C. Buckenmaier III MD,

    Corresponding author
    1. Anesthesiology, USUHS, Bethesda, Maryland, USA
    • Defense and Veterans Center for Integrative Pain Management, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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  • Kevin T. Galloway BSN, MHA,

    1. Army Pain Management Task Force, Office of the Army Surgeon General, Falls Church, Virginia, USA
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  • Rosemary C. Polomano PhD, RN,

    1. Pain Practice, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
    2. Anesthesiology and Critical Care (Secondary), University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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  • Mary McDuffie RN, CIV,

    1. Defense and Veterans Center for Integrative Pain Management, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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  • Nancy Kwon CRNP, MSN,

    1. Defense and Veterans Center for Integrative Pain Management, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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  • Rollin M. Gallagher MD, MPH

    1. Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
    2. Pain Policy Research and Primary Care, Penn Pain Medicine, Philadelphia, Pennsylvania, USA
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  • Correction made after online publication November 8, 2012: affiliations have been updated.
  • Funding: This work was supported by institutional funding and the Defense and Veterans Center for Integrative Pain Management.
  • Copyright Protection: Our team is comprised partly of military service members and employees of the US Government. This work was prepared as part of our official duties. Title 17 U.S.C. 105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. 101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person's official duties.
  • Disclaimer: The views expressed in this presentation are those of the authors and do not necessarily reflect the official policy of the Department of the Army, the Department of Defense, or the United States Government.

Reprint requests to: Chester C. Buckenmaier III, MD, DVCIPM, 11300 Rockville Pike, Suite 709, Rockville, MD 20852, USA. Tel: 301-816-4710; Fax: 301-816-4705; E-mail: cbuckenmaier@dvcipm.org.

Abstract

Background.

The Army Surgeon General released the Pain Management Task Force final report in May 2010. Among military providers, concerns were raised that the standard numeric rating scale (NRS) for pain was inconsistently administered and of questionable clinical value. In response, the Defense and Veterans Pain Rating Scale (DVPRS) was developed.

Methods.

The instrument design integrates pain rating scale features to improve interpretability of incremental pain intensity levels, and to improve communication and documentation across all transitions of care. A convenience sample of 350 inpatient and outpatient active duty or retired military service members participated in the study at Walter Reed Army Medical Center. Participants completed the five-item DVPRS—one pain intensity NRS with and without word descriptors presented in random order and four supplemental items measuring general activity, sleep, mood, and level of stress and the Brief Pain Inventory seven interference items. Using systematic sampling, a random sample was selected for a word descriptor validation procedure matching word phases to corresponding pain intensity on the NRS.

Results.

Parallel forms reliability and concurrent validity testing demonstrated a robust correlation. When the DVPRS was presented with the word descriptors first, the correlation between the two ratings was slightly higher, r = 0.929 (N = 171; P < 0.001), than ordering first without the descriptors, r = 0.882 (N = 177; P < 0.001). Intraclass correlation coefficient was 0.943 showing excellent alignment of word descriptors by respondents (N = 42), matching them correctly with pain level.

Conclusions.

The DVPRS tool demonstrated acceptable psychometric properties in a military population.

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