Home > cancer

The Faces Pain Scale – Revised: What This Means for Patients

When you’re in the hospital, it’s important that you’re able to communicate exactly how you’re feeling with your care team – especially when it comes to your pain.

Many health care systems have been relying on the Wong-Baker Faces scale to assist children and low health literacy patients in determining the level of pain they are experiencing, but there’s an issue with this scale. “The old faces pain scale, developed by Donna Wong and Connie Baker, was found, in some research studies, to measure mood rather than pain,” Lynne Brophy RN, of the TriHealth Cancer Institute, explains. “Happy little faces were telling nurses and doctors how happy the kid was, not how much pain the kid was in.”

The Faces Pain Scale – Revised: Who Benefits?

If patients are not able to understand the standard 0-10 pain scale, their nurse can request the Faces Pain Scale – Revised, which uses a series of six images, allowing the child or low health-literacy patient, to self-report his or her pain. Low health literacy patients are those who do not know where their stomach or bladder is, for example, and do not know how to assign a number to their pain level, Lynne suggests.

The Faces Pain Scale – Revised: How Does it Work?

Unlike the original version, images on the revised scale do not present smiles or tears, but instead, a series of grimaces.  “Multiple studies in the U.S. have found that Americans often tend to demonstrate grimacing when they are in pain, which is a very common, non-verbal communication,” Lynne explains. “If you look at the new scale, that’s what those faces are doing, whereas if you look at Wong-Baker, the faces are smiling and frowning.”

When measuring pain, the nurse asks questions like:

  • Where is your pain?
  • What does the pain feel like?
  • Does the pain radiate?
  • What makes the pain better or worse?

Once the patient expresses the type and level of pain he or she is experiencing, he or she will be prescribed a therapy that will most effectively alleviate that pain, whether it’s a medication, or non-pharmacological pain intervention, like distraction, prayer, music therapy, art therapy or acupuncture.

What's The No. 1 Thing to Remember About Pain Management?

In some cases, concerned family members or friends may try to assign a number to the pain on behalf of their loved ones; however, Lynne reminds people, "The No. 1 safety thing to remember is that we have to pick the assessment tool the patient is able to use and that only the patient should rate his or her pain."

Faces Pain Scale – Revised: 



Tags Cancer , Miscellaneous

Last Updated: April 02, 2014