Pain Clinical Trial
Official title:
Usefulness of a Visual Analogue Scale to Evaluate Anxiety in the Painful Hospitalized Patient
Today, there is no simple tool for measuring patient anxiety. The primary purpose of this study is to evaluate the ability of the Visual Analogue Scale (VAS) to measure anxiety in painful hospitalized patients, and to correlate it to STAI-Ya and HAD-7A auto questionnaires.
Pain is one of the major signs, if not the first, which encourages patient to call
caregivers. It is a complex and multidimensional sensorial experience. An optimal pain
management should consider these different dimensions. If not, the risk is to misidentify
pain causes, resulting in therapeutic failures.
Anxiety is one of these dimensions. It's an emotional factor particularly frequent in
hospitalized patient.
Pain and hospitalization are both sources of anxiety. Anxiety causes discomfort, hyper
vigilance reactions and pain focusing; it can cause avoidance behavior and non-compliance
with prescribed medical treatments. Specific care of anxiety can result in a positive impact
on hospitalized patient's pains and comfort.
Screening tools for anxiety exist. The STAI-Y is the actual reference scale to measure
anxiety. The "Ya" version measures anxiety linked with the reactional state. It's composed of
20 questions and scores of 45 and higher define a significant anxiety (at least moderate).
Another tool, the HAD scale, measures anxiety and depression. It has been validated on a
population of hospitalized patients. It's composed of 14 questions including 7 about anxiety
(HAD-7A). An 11 and higher score defines a significant anxiety (at least moderate). But these
tools, theoretically accessible to caregivers, are not often used, especially in
hospitalization. The principal reason is their inadequacy to the real conditions in services.
Their utilization is too restrictive to hope for an exhaustive diagnosis in routine clinical
practice (e.g. the need to have a specific support at disposal or the time to fill in the
auto-questionnaires). It would be particularly pertinent to have a faster and easier tool at
disposal.
Studies suggest the usefulness of the Visual Analog Scale (VAS) to measure anxiety in
pre-operatory or pre-interventional context. This study aims at evaluating VAS' interest in a
very frequent situation, the one of painful hospitalized patient. If the VAS demonstrates its
capacity to detect and measure anxiety as the validated scales, its utilization could be
proposed at the same time as VAS for pain. When pain is assessed by VAS, it'd be easy and
simple to evaluate anxiety with the anxiety-VAS, with the same tool, systematically or in
anxiety identified situations. Anxious patients who could have specific treatments for
anxiety would be better detected and cared for in a general way in accordance with good
practice recommendations.
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