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Multicenter Study
. 2020 Dec;21(6):572-578.
doi: 10.1016/j.pmn.2020.03.004. Epub 2020 May 1.

Usefulness of a Visual Analog Scale for Measuring Anxiety in Hospitalized Patients Experiencing Pain: A Multicenter Cross-Sectional Study

Vincent Ducoulombier  1 , Roman Chiquet  2 , Sahara Graf  3 , Bernard Leroy  4 , Guillaume Bouquet  5 , Stéphane Verdun  3 , Fabienne Martellier  2 , Adeline Versavel  2 , Alexandre Kone  6 , Karine Lacroix  7 , Didier Duthoit  8 , Quentin Lenglet  8 , Amelie Devaux  9 , Robert Jeanson  9 , Antoine Lefebvre  10 , Benoit Coviaux  11 , Gauthier Calais  12 , Adeline Grimbert  13 , Marie Ledein  14 , Marie Moukagni  15 , Tristan Pascart  16 , Eric Houvenagel  16
Affiliations
Multicenter Study

Usefulness of a Visual Analog Scale for Measuring Anxiety in Hospitalized Patients Experiencing Pain: A Multicenter Cross-Sectional Study

Vincent Ducoulombier et al. Pain Manag Nurs. 2020 Dec.

Abstract

Background: Anxiety is common in hospitalized patients and can worsen pain or lead to unsuccessful pain relief.

Aims: The purpose of this study was to evaluate the usefulness of measuring anxiety with a visual analog scale (VAS) in the hospitalized patient experiencing pain.

Design: We conducted a multiple-center cross-sectional study.

Participants/subjects: Adult inpatients experiencing moderate to severe pain defined by a pain VAS score ≥40 of 100 were included.

Methods: Pain and anxiety data were collected using the following instruments: pain VAS, anxiety VAS, State Anxiety Scale of the Spielberger State-Trait Anxiety Inventory (STAI-YA) and Anxiety Subscale of the Hospital Anxiety and Depression Scale (HAD-A).

Results: Data were collected from 394 patients. Of those patients, 43.6% (171 of 392) and 36.6% (143 of 391) had significant anxiety according to STAI-Ya and HAD-A, respectively. Correlation was good between anxiety-VAS and STAI-YA (ρ = 0.67 [95% confidence interval 0.61-0.72]) and moderate between anxiety VAS and HAD-D (ρ = 0.48 [0.39-0.56]). The main factor predictive of situational anxiety was history of anxiety-depression symptoms (odds ratio = 2.95 [1.93-4.56]). For anxiety VAS score ≥ 40 of 100, the sensitivity for detecting anxiety was 81% with 70% specificity.

Conclusion: This study confirmed the high prevalence of anxiety among inpatients experiencing pain, demonstrated the capacity of a VAS to assess this anxiety, determined an anxiety VAS cutoff level to screen for significant anxiety, and identified risk factors of anxiety in this population. Anxiety VAS has been found to be an easy-to-use method familiar to caregivers, with all the advantages needed for an effective screening instrument. An anxiety VAS score ≥40 of 100 would thus warrant particular attention to adapt care to the patient's anxiety-related pain and initiate specific therapeutic interventions.

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