The validity of intermittent questioning about possible change in pain intensity is poor. The VRS is reliable for assessment of pain after hip fracture. Unweighted kappa coefficients of agreement in recalled pain compared to agreement of paired VRS scores ranged from 0.57 (95% CI = 0.49–0.65) to 0.36 (95% CI = 0.31–0.41). Paired scores with maximum disagreement of one scale point reached 97% at rest and 95% at straight leg raise. Cognitive status was quantified by the short Orientation-Memory-Concentration Test. Reliability of this assessment of pain using the VRS was compared to the validity of assessing possible change in pain from the selected descriptors. Agreement between paired measures on the VRS at rest and by passive straight leg raise with a one-minute interval between ratings at rest and three-minute interval for straight leg raise was expressed by kappa coefficients.
Furthermore, patients described the changes in pain after raising their leg, with one of five descriptors.
Patients prospectively rated pain on the VRS. Hip fracture patients represent a challenge to pain rating due to the high prevalence of cognitive impairment.
