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How well does the Wong-Baker FACES scale identify the variation of pain?
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
2013 (English)In: Fechner Day 2013: Proceedings of the 29th Annual Meeting of the International Society for Psychophysics / [ed] Jiri Wackermann, Marc Wittmann, Wolfgang Skrandies, Freiburg, Germany: International Society for Psychophysics , 2013, 97-97 p.Conference paper, Abstract (Other academic)
Abstract [en]

Pain is one of the most common symtoms reported clinically. Apart from the Visual Analogue scale, several rating scales are used varying in degree of interpretability and suitability for various types of pain. One scale often used, especially for children, is the Wong–Baker FACES Pain Rating Scale where pain is expressed in six drawn faces varying in expression from (1) a smiling face denoting “no hurt” to (6) a crying face for “hurts worst”. Two experiments were carried out. Firstly, 12 university professors of psychology (8 men and 4 women, 50–79 yrs) answered where (in what face) they judged that pain with certainty started. Three answered that pain started in the sixth face. Two said that no face showed pain and the rest said that the dimension shown was degree of happiness-sadness. However, if the intensity of pain was estimated as if using cross-modality matching (sadness to pain), three said face no. 4, one no. 4-5, one no. 4,5, or 6, and two said face number 5 (median = 4.5). Secondly, sixteen university students (4 men and 12 women, mean age = 27.2, SD = 7.4 yrs) answered the same question as above and then also used the Borg CR100 (centiMax) Scale®  , a general 0—100 intensity Category-Ratio scale for most kinds of subjective measurement3 , to scale the pain intensity expressed in each of the six faces (presented twice in a randomized order in a Powerpoint presentation). Pain was “with certainty” judged to start at the fifth face, and several participants scaled the first two faces as “zero pain”. A continuous progression of pain intensity for the six faces was on the average obtained with the CR100 scale: medians = 0.0, 0.5, 11, 31, 48, 72 centiMax. Thus, expressed with the verbal labels on the CR100 scale, the first two faces were below “Minimal”, which indicates that these faces were not judged to show any pain, the third face was just above “Weak” (13), the fourth face just above “Moderate” (25), the 5th face just below “Strong” (50) and the 6th face was just below “Very strong” (70). The conclusion was that the faces only with hesitation can be used to estimate pain. The last face was not judged to show more than a very strong pain, thus causing a restriction of range and a ceiling effect. Aproblem with these kinds of scales is poor congruence between pictures, verbal labels and numbers.

Place, publisher, year, edition, pages
Freiburg, Germany: International Society for Psychophysics , 2013. 97-97 p.
, Fechnerday Proceedings
Keyword [en]
pain, psychophysical scaling, Borg CR100 Scale
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Research subject
URN: urn:nbn:se:su:diva-98785OAI: diva2:685449
Fechner Day 2013
Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2014-07-08Bibliographically approved

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