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Measuring the Pain of Mucositis using Oucher and DEGR

Richard Hain, Meriel Jenney, Ben Carter and Ruth Davies

Aim: To measure pain in mucositis using two pain scales of contrasting design (DEGR and Oucher), and to compare the two scores.
Patients and methods: Children receiving treatment for pain related to cancer therapy on a regional specialist oncology ward were eligible for the study. Children’s pain was scored in parallel using DEGR administered by the ward nurses and Oucher administered by a research nurse.
Results: Thirty families participated in the study. Pain score data were incomplete for nine. 143 DEGR scores and 92 Oucher scores were obtained. Scores from either scale were discarded if too remote (i.e. >4 hours apart) from their paired score from the other. Forty-six complete sets of paired data were obtained from 21 subjects. Mucositis pain persisted for several days. Oucher scores were significantly and inversely influenced by time while DEGR scores were not, such that scores diverged after three days.
Conclusions: Pain persisted despite intensive treatment. Behaviour patterns associated with persistent pain seemed to become apparent during acute episodes of mucositis. Our data suggest DEGR was more sensitive to persistent pain than the Oucher but patient numbers were small.