A randomized comparative study assessing efficacy of pain versus comfort scores

CONTEXT: Use of language with negative emotional content is likely to increase patient's pain and anxiety. AIMS: We designed a single-blinded randomized study to compare pain scores with comfort scores and to determine whether the technique of pain assessment affects patient's perceptions and experience. SUBJECTS AND METHODS: After cesarean section, 180 women were randomized before postanaesthesia interview into two groups. Group P women were asked to rate their pain on a 0–10-point verbal numerical rating scale (VNRS) for pain while Group C women were asked to rate their comfort on a 0–10-point VNRS for comfort. All women were asked whether the surgical wound was associated with injury or healing. The primary outcomes were to compare the incidence of reported pain and to assess pain severity as measured by a 0–10-point VNRS for pain compared with an equivalent inverted VNRS for comfort. The secondary outcomes were whether the wound was associated with injury or healing. STATISTICAL ANALYSIS USED: Data were analyzed using Student's t-test and nonparametric Mann–Whitney U-test, performed at a significance level of α =0.05. RESULTS: In Group P, 62 women (68.9%) reported pain compared with only 49 women (54.4%) in Group C (P < 0.05). There were no significant differences between groups for VNRS at rest and on movement. In Group P, thirty women (33.33%) reported sensations as injury compared with only 11 women (12.22%) in Group C (P < 0.001). CONCLUSIONS: Assessment of pain using positive word like comfort decreases its incidence with no effect on its severity when measured by comfort score and also affects patient's postsurgical perceptions.