Comparison of four unidimensional pain scales and women's preferences during the first stage of labor: a cross-sectional study.

BACKGROUND: To compare four unidimensional pain assessment scales during the first stage of labor by evaluating agreement among the scales and women's preferences for pain assessment tools in a clinical setting. METHODS: A cross-sectional comparative study was conducted between August 2023 and June 2024 with 135 women who experienced spontaneous vaginal births at a state hospital in Türkiye. Four commonly used unidimensional pain scales-the Visual Analog Scale (VAS), Facial Pain Scale (FPS), Numerical Rating Scale (NRS), and Verbal Descriptive Scale (VDS)-were compared in terms of inter-scale agreement during the latent and active phases of labor. Participants were also asked to indicate their preferred pain scale. RESULTS: The FPS was the most preferred scale, chosen by 41.5% of the women. All four pain scales showed strong, positive, and statistically significant correlations during both the latent and active phases of labor (p < 0.001). The intraclass correlation coefficient (ICC) for pain scores among the scales was 0.941 (F = 17.063, p < 0.001) during the latent phase and 0.932 (F = 14.679, p < 0.001) during the active phase. CONCLUSIONS: The Facial Pain Scale demonstrated the highest preference and reliability among women during labor, whereas the Visual Analog Scale was rated lower in both preference and consistency. These findings highlight the importance of using appropriate and patient-centered tools in labor pain management.