Rating Dyspnea and Pain: "No" is Not Always "Zero".
Kathy M Baker, Alison M Phelan, Jennifer B Reilly and 3 others
PMID 36367118WHAT IT FOUND
Recording a no answer as zero for breathing discomfort or pain misses real symptoms.
Ask for a numeric rating even after no, because a low score can still mean discomfort.
Key findings
0127% of patients who answered no to breathing discomfort rated it above zero.
0253% of patients who answered no to pain rated it above zero.
03All patients who answered yes rated the symptom above zero.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a pilot with a convenience sample of 60 patients at one hospital. It had no sample size calculation and was exploratory. It did not record demographics, medical records, or diagnoses, so the patients' conditions cannot be judged. It did not follow patients or measure clinical outcomes. The interviewers were nurses who were also authors. The study asked only about current symptoms at rest.
Declared interests
No conflicts of interest statement is included in the article text. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that a no answer always means no symptom. This was a small pilot in one hospital, and the study did not test whether changing the question improves patient outcomes.