Development and Validation of a Culturally-Relevant Pain Scale for Kiswahili-Speaking Patients in a Tanzanian Emergency Department
Background: Acutely painful conditions, responsible for a large proportion of Emergency Department patients around the world, are inadequately assessed and poorly treated. Routine use of scales to quantify pain is recommended to improve analgesic practice. Currently, no such scale has been validated for use in Kiswahili-speaking patients in Tanzania. The objective of this study was to develop and assess a culturally relevant pain intensity scale for use in injury patients at the Kilimanjaro Christian Medical Center in Moshi, Tanzania. Methods: This was a two-part study, with the initial phase using focus groups to develop a pain scale. The second phase used a convenience sample of injury patients to assess the scale for validity and reliability. Analysis of variance, intra-class correlation coefficients, and Bland-Altman Analysis were used to assess validity and reliability. We used focus groups and surveys to develop a pain scale, which was subsequently tested in injury patients. Results: A 100-point numeric pain scale was developed and tested among 98 injury patients. The intra-class correlation coefficient of scores was 0.97 (95% CI 0.96 - 0.98) and Bland-Altman analysis found that 95% of the differences were between -23.5 and +20.7. Conclusions: Our results suggest that a 100-point numeric rating scale is valid and reliable for use Tanzanian injury patients.
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