Abstract
Evaluating pain in verbal children in the hospital setting is done primarily through
serial assessments of pain intensity using single-item measures. However, little remains
known about intensity scales' relative responsiveness and uniqueness from negative
affect in this clinical setting. In the present study, a total of 411 assessments
using 3 common pediatric pain intensity measures (the Faces Pain Scale-Revised, a
verbally presented numeric rating scale, and a visual analog scale) were obtained
over a period of 3 days from 29 children ages 9 to 18 years following a relatively
standardized surgical procedure. Hierarchical linear models were used to compare the
3 scales on responsiveness over postoperative recovery time, invariance across baseline
variables (age, sex, and baseline mood), and distinctiveness from changes in negative
affect. Results showed that all 3 pain-intensity measures were highly interrelated,
varied similarly with age and baseline state anxiety, and were comparably related
to contemporaneous changes in affect. However, patients tended to rate pain intensity
higher on the Numerical Rating Scale, and only this scale failed to reflect a decreasing
trend in pain scores with elapsed surgical recovery time. Potential implications for
clinical practice are discussed.
Perspective
This article presents data comparing the responsiveness over time and association
with negative affect of 3 single-item pediatric pain-intensity scales commonly used
in hospital settings. The results can help inform the selection of self-report measures
when serially evaluating pain and treatment response in hospitalized children.
Key words
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Article info
Publication history
Published online: June 21, 2010
Accepted:
April 21,
2010
Received in revised form:
March 30,
2010
Received:
December 2,
2009
Footnotes
Funded by an intramural grant from the Katherine B. Richardson Foundation.
Identification
Copyright
© 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
