Original Research

A verbal descriptor incremental pain scale developed by South African Tswana-speaking patients with low back pain

Michelle Yazbek, Aimee V. Stewart, Alison Bentley
South African Journal of Physiotherapy | Vol 74, No 1 | a460 | DOI: https://doi.org/10.4102/sajp.v74i1.460 | © 2018 Aimee V. Stewart | This work is licensed under CC Attribution 4.0
Submitted: 16 March 2018 | Published: 30 August 2018

About the author(s)

Michelle Yazbek, Department of Physiotherapy, University of the Witwatersrand, South Africa
Aimee V. Stewart, Department of Physiotherapy, University of the Witwatersrand, South Africa
Alison Bentley, Department of Family Medicine, University of the Witwatersrand, South Africa

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Background: Measuring pain in patients whose home language is not English can be difficult as there may not be a scale available in their home language. Scales devised in other countries may also not be accurate after translation.

Objectives: The aim of this study was to develop and test a new verbal pain descriptor scale in a Tswana-speaking population in South Africa with low back pain.

Method: Two separate Tswana-speaking groups (20 males and 20 females) of patients with low back pain were asked to describe each of four categories of pain: mild, moderate, severe and worst. They then voted and descriptions obtaining more than 70% of the vote were taken to the next round of voting with both groups together. A final scale of one description for each category of pain (Tswana Verbal Pain Descriptor Scale – TVPDS) for both males and females was tested on a sample of 250 patients with low back pain and against three other non-verbal pain scales.

Results: All items on the final scale were approved by at least 70% of both male and female participants. The scores for the TVPDS correlated well with present pain perception (r = 0.729, p < 0.0001) measured on the numerical visual analogue scale. The TVPDS correlated well with the Wong–Baker FACES Pain Rating Scale (r = 0.695, p < 0.0001) and the Pakistani Coin Pain Scale (r = 0.717, p < 0.0001).

Conclusion: The TVPDS has the potential to be a useful clinical scale but more testing in other languages is still required.

Clinical implications: This pain scale has the potential to be a useful scale to use for Tswana-speaking persons with low back pain and could also be useful for persons of other languages, if translated.


Tswana; pain scales; verbal pain descriptors; low back pain


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