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Rating Dyspnea and Pain: “No†is Not Always “Zeroâ€

Author

Listed:
  • Kathy M. Baker
  • Alison M Phelan
  • Jennifer B Reilly
  • Robert W. Lansing
  • Richard M Schwartzstein
  • Robert B. Banzett

Abstract

Nurses routinely assess pain in hospitalized patients; similar assessment of dyspnea is increasing. Most nurses start with a yes–no question when assessing pain or dyspnea; many record “no†as a zero rating, skipping the rating scale. We tested the hypothesis that recording “no†answers as “zero†fails to detect the symptoms that would have been detected with a rating scale. Nurses asked 60 patients yes–no questions about the presence of dyspnea and pain, then asked patients to rate the symptoms using a 0–10 scale. All “yes†answers were followed by a concordant rating (i.e., greater than zero). More than 25% of “no†answers were followed by a discordant rating (> zero). Documenting “no†as “zero†missed information potentially useful in care planning; patients who rate dyspnea above zero are at greater risk of adverse outcomes. This information can also provide opportunity to start a discussion with patients who may benefit from symptom management.

Suggested Citation

  • Kathy M. Baker & Alison M Phelan & Jennifer B Reilly & Robert W. Lansing & Richard M Schwartzstein & Robert B. Banzett, 2023. "Rating Dyspnea and Pain: “No†is Not Always “Zeroâ€," Clinical Nursing Research, , vol. 32(1), pages 15-21, January.
    • Handle: RePEc:sae:clnure:v:32:y:2023:i:1:p:15-21
    DOI: 10.1177/10547738221134564
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