Defense and Veterans Pain Rating Scale

SEVERE
(Red)
MODERATE
(Yellow)

MILD
(Green)

No pain Hardly Notice Some- Distracts Interrupts Hard to Focus of Awful, Can’t bear As bad as
notice pain, times me, can some ignore, attention, hard to do the pain, it could
pain does not distracts do usual activities avoid prevents anything unable to be,
interfere me activities usual doing do nothing
with activities daily anything else
activities activities matters
v2.1

DVPRS
DVPRS Supplemental
Supplemental Questions
DVPRS
DVPRS Supplemental QQuestions
Supplemental Questions
uestions
For
For clinicians to evaluate the biopsychosocial impact of pain
For clinicians
clinicians to
to evaluate
evaluate the
the biopsychosocial
biopsychosocial impact
impact of
of pain
pain
ForFor clinicianstotoevaluate
clinicians evaluatethe
the biopsychosocial
biopsychosocial impact
impactofofpain
pain
1.
1. Circle
Circle the
the one
one number
number that
that describes
describes how,
how, during
during the
the past
past 24
24 hours,
hours, pain
pain has
has interfered
interfered with
with your
your usual
usual ACTIVITY:
ACTIVITY:
1.
1. Circle
Circle the
the one
one number
number that
that describes
describes how,
how, during
during the
the past
past 24
24 hours,
hours, pain
pain has
has interfered
interfered with
with your
your usual
usual ACTIVITY:
ACTIVITY:
0
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8
8 9
9 10
10
0
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8
8 9
9 interferes10 10
Does not interfere
Does not interfere Completely
Completely interferes
Does
Does not
not interfere
interfere Completely interferes
Completely interferes

2.
2. Circle
Circle the
the one
one number
number that
that describes
describes how,
how, during
during the
the past
past 24
24 hours,
hours, pain
pain has
has interfered
interfered with
with your
your SLEEP:
SLEEP:
2.
2. Circle
Circle the
the one
one number
number that
that describes
describes how,
how, during
during the
the past
past 24
24 hours,
hours, pain
pain has
has interfered
interfered with
with your
your SLEEP:
SLEEP:
0
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8
8 9
9 10
10
0
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8
8 9
9 interferes10 10
Does not interfere
Does not interfere Completely
Completely interferes
Does
Does not
not interfere
interfere Completely interferes
Completely interferes

3.
3. Circle
Circle the
the one
one number
number that
that describes
describes how,
how, during
during the
the past
past 24
24 hours,
hours, pain
pain has
has affected
affected your
your MOOD:
MOOD:
3.
3. Circle
Circle the
the one
one number
number that
that describes
describes how,
how, during
during the
the past
past 24
24 hours,
hours, pain
pain has
has affected
affected your
your MOOD:
MOOD:
0
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8
8 9
9 10
10
0
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8
8 9 9 10 10
Does not affect
Does not affect Completely
Completely affects
affects
Does
Does not
not affect
affect Completely affects
Completely affects

4.
4. Circle
Circle the
the one
one number
number that
that describes
describes how,
how, during
during the
the past
past 24
24 hours,
hours, pain
pain has
has contributed
contributed to
to your
your STRESS:
STRESS:
4.
4. Circle
Circle the
the one
one number
number that
that describes
describes how,
how, during
during the
the past
past 24
24 hours,
hours, pain
pain has
has contributed
contributed to
to your
your STRESS:
STRESS:
0
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8
8 9
9 10
10
0
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8 9
8Contributes 10
9 a great deal
10
Does not contribute
Does not contribute Contributes a great deal
Does
Does not
not contribute
contribute Contributes
Contributes a
a great
great deal
deal
*Reference for pain interference: Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore 23(2): 129-138, 1994.
*Referencefor
for paininterference:
interference: Cleeland CS, Ryan KM. Pain assessment: global use ofBrief
the Brief Pain Inventory. Ann Med
Acad Med Singapore 23(2): 129-138,
*Reference
*Reference forpain
pain interference:Cleeland CS,
Cleeland Ryan
CS, KM.
Ryan Pain
KM. assessment:
Pain global
assessment: use of
global usethe Pain Inventory.
of the Brief Ann Acad
Pain Inventory. Ann AcadSingapore 23(2): 129-138,
Med Singapore 1994. 1994.
23(2): 129-138, v 2.1
1994.
*Reference for pain interference: Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore 23(2): 129-138, 1994.