Measurement of Acute Pelvic Pain Intensity in Gynecology A Comparison of Five Methods

OBJECTIVE: To compare different methods for measuring pelvic pain intensity in a gynecologic emergency unit. METHODS: A total of 177 consecutive female patients, with or without pain, consulting in a gynecologic emergency unit, underwent initial pain evaluation. We used three self-report pain intensity scales: visual analog scale, numeric rating scale, and verbal rating scale, and two nonverbal structured behavioral indices (BI-1, first behavioral index, BI-2 second behavioral index). Diagnosis and treatment took place in routine manner. RESULTS: The five scales were unidimensional according to principal component analysis (Cronbach's alpha coefficient=0.89). Missing data rates were greater for the two behavioral scales than for the self-report scales (n=177; 6.2% for BI-1 and 12.4% for BI-2). Patients had lower scores with the behavioral scales than with the self-report ones. Variations of pain intensity according to the pain physiology or the pain location were similar whatever the method of measurement used. The five methods were a sensitive to the physiology of the pain, the location and the severity of the illness, and pain as a main complaint. None of the methods used was affected by age, occupational categories, parity, or geographical origins. CONCLUSION: All methods adequately measured the pelvic pain intensity in gynecologic emergencies. The self-report scales were easier to use than the behavioral indices. Self-report measurements of pelvic pain intensity provide useful information at the time of triage in gynecologic emergency departments.