The Wong-Baker Faces Pain Rating scale is a self-assessment tool that can help people communicate about their physical pain. It uses a combination of faces, numbers, and words, providing multiple ways for a person to express their pain level.
The Wong-Baker Faces Pain Rating Scale is a method for someone to self-assess and effectively communicate the severity of pain they may be experiencing. The scale contains a series of six faces ranging from a happy face at 0 to indicate “no hurt” to a crying face at 10 to indicate “hurts worst.”
Using faces, numbers, and short phrases helps provide multiple ways for someone to understand what level of pain they may be experiencing. Subsequently, this allows them to communicate this to a healthcare professional. This may allow them to perform the necessary actions to help ease any discomfort the individual may be experiencing.
In this article, we will discuss the Wong-Baker Faces Pain Rating Scale, including what it involves, its possible uses, and its benefits. We also look at any disadvantages and frequently asked questions.
Donnie Wong and Connie Baker developed The Wong-Baker Faces Pain Rating Scale in 1983. Their research identified that children had difficulty rating their pain with numbers yet responded well to facial expressions. Consequently, they developed the scale to help children better communicate their pain.
To develop the scale, Donnie Wong and Connie Baker requested children in a hospital setting to draw facial expressions that reflected how they felt when they experienced different pain levels.
A professional artist then took the most commonly drawn features by the children and developed the faces into the current versions on the scale.
The scale starts at 0 and ends at 10, with the numbers increasing in intervals of 2. Each number relates to both a face and a small descriptive phrase. It is flexible because if someone uses the numbers, they may not need the faces or the wording.
The phrase relating to each numerical value is as follows:
- 0: no hurt or pain
- 2: it hurts a little bit
- 4: it hurts a little more
- 6: it hurts even more
- 8: it hurts a whole lot
- 10: it hurts the worst
However. since its development, researchers have identified that the scale is suitable for adults. For example, a 2018 study used the scale to measure pain levels for people attending the emergency department with extremity traumas.
A healthcare professional will ask people to rate their pain by considering the faces, numbers, and descriptions. Ideally, a healthcare professional would introduce the scale when a person is not experiencing pain, for example, before an operation. However, this may not be possible in emergencies.
For this scale to be effective, the person must understand what it is for and how to use it. Depending on how they rate their pain, medical staff can decide the best way to treat it.
Older research suggests the scale may be a suitable method for older adults with mild to moderated cognitive impairment to communicate their pain level.
Moreover, using facial expressions may mean that people can express their pain levels in instances where a language barrier with a healthcare professional may exist.
Despite its use in research and clinical settings, the Wong-Baker Faces Pain Rating Scale has some disadvantages.
Secondly, children may find the scale confusing, where regardless of pain, their face might not reflect the face on the scale. They may interpret the expressions rather than see them as a means to describe their physical pain.
Some common questions about the Wong-Baker Faces Pain Rating Scale include the following.
What types of pain does the scale measure?
The Wong-Baker Faces Pain Rating Scale only measures physical pain. Therefore, it is unsuitable for assessing comfort, mood, or emotions.
How does this scale differ from the Numeric Pain Rating Scale?
The Numeric Pain Rating Scale is an 11-point scale for people to self-report pain intensity. Similarly to the Wong-Baker Faces Pain Rating Scale, 0 represents “no pain,” while 10 indicates the worst pain imaginable.
However, the key difference is the numeric pain rating scale relies solely on numbers and does not include the visual of facials as the Wong-Baker Faces Pain Rating Scale does.
Is the scale suitable for everyone?
The scale is unsuitable for assessing pain in unresponsive people. It is also not suitable for those under 3 years of age.
Furthermore, as a person must understand how to use the scale, older research suggests it may not be appropriate for those with severe cognitive impairments.
Additionally, the scale is not suitable for use by third parties, for example, a spouse or parent of someone in pain.
The Wong-Baker Faces Pain Rating Scale is a tool that uses a combination of faces, numbers, and words to help a person effectively communicate the severity of their physical pain.
It is a suitable tool for those aged 3 years and over but may be unsuitable for those with severe cognitive impairments.