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Miró Martínez, JordiAuthorSole Pijuan, EsterAuthorDe La Vega RAuthorGalán SAuthorSolé EAuthorMiro JAuthor

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June 12, 2020
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What Determines Whether a Pain is Rated as Mild, Moderate, or Severe? the Importance of Pain Beliefs and Pain Interference

Publicated to:Clinical Journal Of Pain. 33 (5): 414-421 - 2017-05-01 33(5), DOI: 10.1097/AJP.0000000000000429

Authors: Jensen, Mark P; Tome-Pires, Catarina; de la Vega, Rocio; Galan, Santiago; Sole, Ester; Miro, Jordi

Affiliations

Harborview Medical Center - Author
Inst Invest Sanitaria Pere Virgili, Catalonia, Spain - Author
Institut d'Investigació Sanitària Pere Virgili - Author
Res Ctr Behav Assessment CRAMC, Dept Psychol, Catalonia, Spain - Author
Res Ctr Behav Assessment CRAMC, Unit Study & Treatment Pain ALGOS, Catalonia, Spain - Author
Research Center for Behavior Assessment (CRAMC) - Author
Unit for the Study and Treatment of Pain - Author
Univ Rovira & Virgili, Fdn Grunenthal, Catalonia, Spain - Author
Univ Washington, Dept Rehabil Med, POB 359612,325 Ninth Ave, Seattle, WA 98104 USA - Author
Universitat Rovira i Virgili - Author
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Abstract

© 2016 Wolters Kluwer Health, Inc. All rights reserved. Summary Reliable and valid measures of pain intensity are needed to accurately evaluate the efficacy of pain treatments. Perhaps with the exception of faces pain intensity scales, which are thought to reflect both pain intensity and pain affect, the other most commonly used pain intensity scales-Numerical Rating Scales (NRSs), Visual Analog Scales, and Verbal Rating Scales (VRSs)- A re all thought to reflect primarily pain intensity or the magnitude of felt pain. However, to our knowledge, this assumption has not been directly tested for VRSs. Methods We evaluated whether VRS pain severity ratings are influenced by pain beliefs, catastrophizing, or pain interference over and above any effects of pain intensity, as measured by a NRS, in 4 samples of individuals with physical disabilities and chronic pain. Results As hypothesized, and while controlling for pain intensity as measured by a NRS, higher scores on factors representing pain interference with function, pain catastrophizing, and a number of pain-related beliefs were all associated with a tendency for the study participants to rate their pain as more severe on a VRS. Discussion These findings indicate VRSs of pain severity cannot necessarily be assumed to measure only pain intensity; they may also reflect patient perceptions about pain interference and beliefs about their pain. Clinicians and researchers should take these findings into account when selecting measures and when interpreting the results of studies using VRSs as outcome measures.

Keywords

CatastrophizationChronic painCultureFemaleHumansIndividuals with disabilitiesMaleMiddle agedPain assessmentPain measurementPain perceptionPain ratingPsychosocial factorsSeverity of illness index

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Clinical Journal Of Pain due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2017, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Anesthesiology and Pain Medicine.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 3.6. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 3.49 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 21.37 (source consulted: Dimensions Aug 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-08-02, the following number of citations:

  • WoS: 70
  • Scopus: 75
  • Europe PMC: 36
  • Google Scholar: 114

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-08-02:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 174.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 176 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 33.95.
  • The number of mentions on the social network Facebook: 6 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 49 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (MIRO MIRO, JOSE M.).