Psychometric Testing of the Defense and Veterans Pain Rating Scale (DVPRS): A New Pain Scale for Military Population.

OBJECTIVE: The Defense and Veterans Pain Rating Scale (DVPRS 2.0) is a pain assessment tool that utilizes a numerical rating scale enhanced by functional word descriptors, color coding, and pictorial facial expressions matched to pain levels. Four supplemental questions measure how much pain interferes with usual activity and sleep, and affects mood and contributes to stress. METHODS: Psychometric testing was performed on a revised DVPRS 2.0 using data from 307 active duty service members and Veterans experiencing acute or chronic pain. A new set of facial representations designating pain levels was tested. RESULTS: Results demonstrated acceptable internal consistency reliability (Cronbach's alpha = 0.871) and test-retest reliability (r = 0.637 to r = 0.774) for the five items. Excellent interrater agreement was established for correctly ordering faces depicting pain levels and aligning them on the pain intensity scale (Kendall's coefficient of concordance, W = 0.95 and 0.959, respectively). Construct validity was supported by an exploratory principal component factor analysis and known groups validity testing. Most participants, 70.9%, felt that the DVPRS was superior to other pain rating scales. CONSCLUSION: The DVPRS 2.0 is a reliable and valid instrument that provides standard language and metrics to communicate pain and related outcomes.

Treating pain on the battlefield: a warrior's perspective.

The current conflicts in Afghanistan (Operation Enduring Freedom; commenced October 2001) and Iraq (Operation Iraqi Freedom; commenced March 2003) have been remarkable due to the more than 90% survival rate among wounded warriors. Although this statistic is a historic achievement by the military's medical services, other medical issues have taken on greater emphasis as more casualties from war survive than ever before. Pain management of United States wounded, in particular, has been a medical issue of increasing importance, as modern understanding of the detrimental effects of pain on recovery and rehabilitation becomes clearer. In this review, a warrior's perspective of military pain management is explored and potential for improvement discussed.