Cited by 2,580Psychometric Methodologies and TestingHealth Education and ValidationPain Management and Opioid Use

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A critical review of visual analogue scales in the measurement of clinical phenomena

Wewers, Mary Ellen, Lowe, Nancy K.·1990·Research in Nursing & Health

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Abstract

Visual analogue scales (VAS) have been used in the social and behavioral sciences to measure a variety of subjective phenomena. The VAS method has potential utility for the measurement of a variety of clinical phenomena of interest to nurse investigators. In this review a description of the various forms of the VAS and an historical overview of their development are presented. In addition, conceptual, psychometric, and statistical aspects of the VAS are considered. Finally, strengths and limitations of the VAS method are addressed.

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Dry Cupping Therapy for Improving Subcutaneous Hemodynamics and Pain Associated With Nonspecific Neck Pain.
Stephens, S. L., Selkow, N., & Hoffman, N. L. (2020) · Journal of athletic training · doi:10.4085/1062-6050-236-19 · Cited by 20
“A VAS was used to measure subjective pain intensity.(17) It contained a 100-mm horizontal line that ranged from 0 (no pain) on the left to 100 (worst pain) on the right.”
Method
Longitudinal Health Status from Early Disease to Adulthood and Associated Prognostic Factors in Juvenile Idiopathic Arthritis
Tollisen, A., Selvaag, A. M., Aasland, A., Lerdal, A., & Flatø, B. (2019) · The Journal of Rheumatology · doi:10.3899/jrheum.180948 · Cited by 29
“94 Living alone, with friends, or in a dormitory, n (%) 32 (33) 27 (28) 0.”
A complex intervention of self‐management for patients with COPD or CHF in primary care improved performance and satisfaction with regard to own selected activities; A longitudinal follow‐up
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Comparative Evaluation of Desensitizing Efficacy of Dentifrice Containing 5% Fluoro Calcium Phosphosilicate versus 5% Calcium Sodium Phosphosilicate: A Randomized Controlled Clinical Trial
Ashwini, S., Swatika, K., & Kamala, D. N. (2018) · Contemporary Clinical Dentistry · doi:10.4103/ccd.ccd_735_17 · Cited by 20
“Sensitivity was measured using a 10 cm VAS score, with the score of 0 being a no‐pain response and a score of 10 being extreme pain or discomfort.[18,19]”
Method
Changes in emotions and personal goals in primiparous pregnant women during group intervention for fear of childbirth
Airo, R., Korja, R., Saisto, T., Rouhe, H., Muotka, J. S., & Salmela‐Aro, K. (2018) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2018.1462477 · Cited by 21
“Subjective FOC was measured with the Visual Analog Scale (VAS; Rouhe et al., 2013; Wewers & Lowe, 1990), ranging from 0 to 10 (from not at all to extremely high).”
Method
The role of physical status versus mental status in predicting the quality of life of patients with lumbar disk herniation
Engel‐Yeger, B., Keren, A., Berkovich, Y., Sarfaty, E., & Merom, L. (2016) · Disability and Rehabilitation · doi:10.1080/09638288.2016.1253114 · Cited by 22
Anxiety Reduction With Music and Tempo Synchronization on Magnetic Resonance Imaging Patients
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“The Visual Analogue Scale (VAS) is a 10 cm long scale, where respondents are asked to mark the line to express freely their feelings about a certain stimulus (Wewers & Lowe, 1990).”
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Cerebral mechanism of puncturing at He-Mu point combination for functional dyspepsia: study protocol for a randomized controlled parallel trial
Yin, S., Chen, Y., Lei, D., Sun, R., Ma, T., Feng, P.-M., He, Z.-X., Suo, X.-L., Ma, P.-H., Qu, Y.-Z., et al. (2017) · Neural Regeneration Research · doi:10.4103/1673-5374.206655 · Cited by 20
“The 10-point visual analogue scale (Wewers and Lowe, 1990) will be used to evaluate needle sensation (deqi) after acupuncture stimulation in the study.”
Method
Are Transitional Vertebra and Spina Bifida Occulta Related with Lumbar Disc Herniation and Clinical Parameters in Young Patients with Chronic Low Back Pain?
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Gait Variability in Chronic Back Pain Sufferers With Experimentally Diminished Visual Feedback: A Pilot Study
Hamacher, D., Hamacher, D., Krowicki, M., & Schega, L. (2016) · Journal of Motor Behavior · doi:10.1080/00222895.2015.1073136 · Cited by 20
“Fourteen healthy participants (M age D 59 § 16 years) not suffering from orthopedic or neurological diseases and 14 CLBP patients (M age D 57 § 15 years; pain lasting for at least three months and reporting a visual analog scale pain score of four or higher; Wewers & Lowe, 1990) were recruited.”
Background
Happy Living in Darkness! Indoor Lighting in Relation to Activities of Daily Living, Visual and General Health in 75-Year-Olds Living at Home
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The Effect of Stretching Hamstring, Gastrocnemius, Iliopsoas and Back Muscles on Pain and Functional Activities in Patients with Chronic Low Back Pain: A Randomized Clinical Trial
Seif, H. E., Alenazi, A. M., Hassan, S. M., Kachanathu, S. J., & Hafez, A. R. (2015) · Open Journal of Therapy and Rehabilitation · doi:10.4236/ojtr.2015.34019 · Cited by 22
“A visual analog scale (VAS) was used in our study for measuring pain severity [23] [24].”
Method
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“Patients were asked to indicate their pain by pointing to the corresponding number on the line 14) .”
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“Hand grip strength and short-form Mc-Gill pain questionnaire subscale scores measured at certain time points and the significance level of the differences between groups at these time points ESWT LASER p Before treatment 18.73±2.87 17.96±2.83 0.303 HGS 4th week 23.73±3.52 21.23±3.44 0.007 12th week 28.83±1.64 25.43±2.…”
Influential
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“The participants ticked on the horizontal line equal to their perception [24-26].”
Background
ASD intervention research in real world contexts: Refining single case designs
Bulkeley, K., Bundy, A., Roberts, J., & Einfeld, S. (2013) · Research in Autism · doi:10.1016/j.rasd.2013.07.014 · Cited by 20
“VASs are also readily transferred onto a variety of electronic and hard copy media for simple and accurate completion (Dale & Hagen, 2007; Wewers & Lowe, 1990).”
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Quality of life and perceived health status in adults with congenitally corrected transposition of the great arteries.
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Trans-areola single-site endoscopic thyroidectomy: pilot study of 35 cases
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Gaming with gaze and losing with a smile
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“After the ten trails participants gave feedback about their gaming experience by marking subjective scores with a pen on a set of Visual Analogue Scales [Wewers and Lowe 1990].”
Method
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Zhang, X., Shao, X., Zhang, Z.-J., Wen, S., Sun, J., & Wang, B. (2012) · Journal of Hand Surgery-American Volume · doi:10.1016/j.jhsa.2011.12.025 · Cited by 20
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“A visual analogue scale (VAS), which was used as a continuous (not categorical) measure to assess pain intensity itself, has assisted other investigators to evaluate the dysmenorrheal pain severity; however, it only offers patients the opportunity to characterize their pain as mild, moderate, severe, or extremely seve…”
BackgroundMethod
Cyclic Sciatica in a Patient With Deep Monolateral Endometriosis Infiltrating the Right Sciatic Nerve
Ceccaroni, M., Clarizia, R., Cosma, S., Pesci, A., Pontrelli, G., & Minelli, L. (2011) · Journal of Spinal Disorders & Techniques · doi:10.1097/bsd.0b013e31820fc53b · Cited by 20
“The woman did not experience pelvic pain at all, foot drop, or pain to her leg after surgery (VAS score=1 for all parameters).(1,7) The voiding function was restored as confirmed at a urogynecologic evaluation.”
Background
Anti-doping education and dietary supplementation practice in Korean elite university athletes
Kim, J., Lee, N., Kim, E.-J., Ki, S., Yoon, J.-R., & Lee, M. (2011) · Nutrition Research and Practice · doi:10.4162/nrp.2011.5.4.349 · Cited by 18
“Recent 1 year training DS and OS practice questionnaires included the following: intake experience (yes or no), intake reasons (openended responses), intake information (open-ended responses), intake informants (open-ended responses), DS use experience immediately before the game (yes or no), DS use informants immedia…”
Method
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Pain experienced by patients during minimal-invasive ultrasound-guided breast biopsy: vacuum-assisted vs core-needle procedure.
Szynglarewicz, B., Matkowski, R., Kasprzak, P., Forgacz, J., Zolnierek, A., Hałoń, A., & Kornafel, J. (2011) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2011.02.002 · Cited by 20
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Bergh, I., Jakobsson, E., & Sjöström, B. (2008) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2007.04506.x · Cited by 20
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Graham, J., Barthlow, D. L., Stein, L. A. R., Ben-Porath, Y., & McNulty, J. L. (2002) · Journal of Personality Assessment · doi:10.1207/s15327752jpa7802_08 · Cited by 20
“Although validity data have not been reported for the analogue scales, previous research supports the use of visual analogue scales to measure clinical phenomena (for a review, see Wewers & Lowe, 1990).”
Method
Perceptual Foreign Accent and its Relevance for Simultaneous Interpreting
McAllister, R. (2000) · Benjamins translation library · doi:10.1075/btl.40.05mca · Cited by 20
“Approximately thirty seconds of each the L2 subjects Swedish speech was judged by thirty three native users of Swedish by means of visual analogue scales (Wewers and Lowe, 1990).”
Method
Identifying feelings engendered during triage assessment in the accident and emergency department: the use of visual analogue scales.
Crouch, R., & Dale, J. (1994) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.1994.tb00402.x · Cited by 20
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Vendrik, J., Vlastra, W., van Mourik, M. V., Delewi, R., Beijk, M., Lemkes, J., Wykrzykowska, J., de Winter, R. D., Henriques, J., Piek, J., et al. (2020) · Netherlands Heart Journal · doi:10.1007/s12471-020-01374-5 · Cited by 19
Does early and late life depression differ in residual symptoms, functioning and quality of life among the first-episode major depressive patients
Xiao, L., Zhou, J., Feng, Y., Zhu, X., Wu, W., Hu, Y., Niu, Y., Hu, J., Wang, X., Gao, C., et al. (2019) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2019.101843 · Cited by 20
Efficacy of Nursing Support in the Pre- and Postmedical Termination of Pregnancy Phases: A Randomized Study
Kaydırak, M. M., & Aslan, E. (2019) · Omega · doi:10.1177/0030222819877791 · Cited by 19
“The scale has a total score range of minimum 0 to maximum 10 (Wewers & Lowe, 1990).”
Background
Patient-reported quality of life and hand disability in elderly patients after a traumatic hand injury – a retrospective study
Reitan, I., Dahlin, L. B., & Rosberg, H. (2019) · Health and Quality of Life Outcomes · doi:10.1186/s12955-019-1215-9 · Cited by 23
“A VAS scale is a 100 mm continuous line with two verbal items in the extremes [42, 43].”
Background
Effectiveness of Non-Animal Chondroitin Sulfate Supplementation in the Treatment of Moderate Knee Osteoarthritis in a Group of Overweight Subjects: A Randomized, Double-Blind, Placebo-Controlled Pilot Study
Rondanelli, M., Braschi, V., Gasparri, C., Nichetti, M., Faliva, M. A., Peroni, G., Naso, M., Iannello, G., Spadaccini, D., Miraglia, N., et al. (2019) · Nutrients · doi:10.3390/nu11092027 · Cited by 37
“The VAS score is determined by measuring in millimeters from the left hand end of the line to the point that the patient marks [29].”
Background
Do health care professionals’ perceptions help to measure the degree of overcrowding in the emergency department? A pilot study in an Italian University hospital
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Authors: Wewers, M. E., & Lowe, N. K.
Affiliations: The Ohio State University (US)
Corresponding author: Wewers, Mary Ellen
ORCID: Lowe, Nancy K.
Venue: Research in Nursing & Health
Publisher: Wiley
Published: 1990-08
Volume: 13
Issue: 4
Pages: 227-236
ISSN: 0160-6891 (ISSN-L)
1098-240X
DOI: 10.1002/nur.4770130405
OpenAlex: W2120263268
Cited by: 2,580
References: 0
Citations by year: 2026: 74 · 2025: 104 · 2024: 87 · 2023: 149 · 2022: 112 · 2021: 160 · 2020: 123 · 2019: 132 · 2018: 137 · 2017: 142 · 2016: 154 · 2015: 143 · 2014: 147 · 2013: 139 · 2012: 128
FWCI: 5.94
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 6015 d)
Locations: Research in Nursing & Health (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Health Sciences › Nursing › Research and Theory › Health Education and Validation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords: visual analogue scale, subjective indicators, clinical phenomena, psychometrics, measurement validity, measurement reliability, patient-reported outcomes
MeSH terms: Humans, Pain Measurement, Psychometrics, Reproducibility of Results, Nursing Research, Clinical Nursing Research

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A critical review of visual analogue scales in the measurement of clinical phenomena

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