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Comparative Prospective Evaluation of the Responsiveness of Single-Item Pediatric Pain-Intensity Self-Report Scales and Their Uniqueness From Negative Affect in a Hospital Setting

  • Mark Connelly
    Correspondence
    Address reprint requests to Mark Connelly, PhD, Assistant Professor of Pediatrics, Pain Management Program, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108.
    Affiliations
    Section of Developmental and Behavioral Sciences, Children's Mercy Hospitals and Clinics, Kansas City, Missouri
    Search for articles by this author
  • Kathleen Neville
    Affiliations
    Section of Pediatric Clinical Pharmacology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri
    Search for articles by this author

      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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