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DVPRS 2.0 Pain Scale Chart for Service Personnel and Veterans

Author: Disabled World : Contact: www.disabled-world.com

Published: 2020-03-12 : (Rev. 2020-03-14)

Synopsis and Key Points:

The Defense and Veterans Pain Rating Scale DVPRS 2.0 is a pain assessment tool using a rating scale, word descriptors, color coding, pictorial facial expressions matching pain levels.

The DVPRS 2.0 is a reliable and valid instrument that provides standard language and metrics to communicate pain and related outcomes.

While the chart is for assessing pain level, it also measures health, sleep, mood, stress, and is widely accepted and used in Veterans Health Administration hospitals.

Main Digest

Pain remains a significant health problem among active duty service members. Pain states often experienced by military populations include musculoskeletal pain, specifically low back pain and joint pain, headaches, and acute and chronic pain from combat injuries. In 2006 alone, 743,547 injury-related musculoskeletal conditions were reported among military service members with 82% attributed to inflammation and pain from exertional overuse

To leverage the best available evidence, clinical expertise, and collaboration to develop and communicate consensus recommendations in support of Air Force, Army, Navy, and VHA pain management practice, education, and research, four supplemental questions measure how much pain interferes with usual activity and sleep, and affects mood and contributes to stress.

Defense and Veterans Center for Integrative Pain Management (DVCIPM)

U.S. Defense and Veterans Pain Rating Scale (DVPRS 2.0)

The U.S. Defense and Veterans Pain Rating Scale (DVPRS 2.0) is a pain assessment tool that utilizes a numerical rating scale enhanced by functional word descriptors, color coding, and pictorial facial expressions matched to pain levels. The DVPRS 2.0 is a reliable and valid instrument that provides standard language and metrics to communicate pain and related outcomes.

The Defense and Veterans Pain Rating Scale, DVPRS, was originally created in 2010 to increase understanding of pain intensity levels among military personnel and veterans experiencing acute or chronic pain. It was also developed to improve communication and documentation during transitions in care of military personnel and veterans. While it includes a numerical scale, it also includes functional word descriptors, color coding and pictures of facial expressions to describe pain levels. Additional questions are included to gather more information about how pain affects everyday activities, such as sleep and mood.

The DVPRS 2.0 has proven to be a reliable, valid and all-encompassing tool for veterans and military personnel alike. While the focus of the scale is for assessing pain levels, it also measures other health factors, such as sleep, mood and stress. Although it is a fairly new pain scale, it has been widely accepted and used in U.S. Veterans Health Administration (VA) hospitals.

Psychometric testing was performed on a revised using data from 307 active duty service members and Veterans experiencing acute or chronic pain. A new set of facial representations designating pain levels was tested. Results demonstrated acceptable internal consistency reliability (Cronbach's alpha = 0.871) and test-retest reliability (r = 0.637 to r = 0.774) for the five items. Excellent inter-rater agreement was established for correctly ordering faces depicting pain levels and aligning them on the pain intensity scale (Kendall's coefficient of concordance, W = 0.95 and 0.959, respectively). Construct validity was supported by an exploratory principal component factor analysis and known groups validity testing. Most participants, 70.9%, felt that the DVPRS 2.0 was superior to other pain rating scales.

Measuring Pain Level with DVPRS 2.0 - How Does the DVPRS 2.0 Scale Work?

The DVPRS 2.0 is a graphic tool clinicians can use to facilitate self-reported pain diagnoses from patients. Look at the Defense and Veterans Pain Rating Scale below and read the descriptions under each number. Please rate the severity of your current pain by circling the corresponding number (0-10). The DVPRS 2.0 also includes an additional visual tool: facial expressions that correspond with each number. The faces range from a full happy face representing a pain level of zero to a grimacing face representing a pain level of 10.

The DVPRS 2.0 consists of a basic traffic-light color code:

DVPRS 2.0 Numerical Pain Scale and Descriptors

Word descriptors are attached to each number on the DVPRS 2.0:

DVPRS 2.0 Numerical Pain Scale and Descriptors
0 No pain
1 Hardly noticeable pain
2 Noticeable pain, but does not interfere with activities
3 Somewhat distracting pain
4 Distracting pain, but does not affect normal activities
5 Pain interrupts some activities
6 Hard to ignore pain, avoidance of daily activities
7 Pain is the main focus of attention, prevents daily activities
8 Awful pain, difficult to do anything
9 Unbearable pain, cannot do anything
10 As bad as pain can be, nothing else matters
DVPRS additional questions

Four supplemental questions are included in the DVPRS to help identify how pain affects an individual's lifestyle. These questions also include a numerical scale that ranges from zero to 10 for each question.

  • Circle the number that describes how pain has interfered with daily activity during the past 24 hours.
  • Circle the number that describes how the pain has affected mood during the past 24 hours.
  • Circle the number that describes how the pain has interfered with sleep during the past 24 hours.
  • Circle the number that describes how the pain has contributed to stress during the past 24 hours.

The Defense and Veterans Pain Rating Scale Chart

DVPRS 2.0 Pain Scale Chart for Service Personnel and Veterans.
DVPRS 2.0 Pain Scale Chart for Service Personnel and Veterans.

DOD/VA  Pain Supplemental Questions

DOD/VA Pain Supplemental Questions.
DOD/VA Pain Supplemental Questions.

A full size printable PDF of both items combined can be download from our reference desk page.

References:

National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health

For an example of the DVPRS, visit https://www.va.gov/PAINMANAGEMENT/docs/DVPRS_2slides_and_references.pdf

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