Highlights
- •We proposed two novel scales to simplify pain assessment in preschool-aged children.
- •The two new scales were compared against the Faces Pain Scale-Revised.
- •Four-year-olds discriminated pain from no-pain better with the new scales.
- •In three-year-olds, pain assessment was not improved with the new scales.
- •Most three-year-olds may be able to report presence but not magnitude of pain.
Abstract
There are inadequate age-specific data to support the use of current self-report pain
scales in 3- and 4-year-old children. Most preschool-aged children also lack the necessary
cognitive development to use standard scales. We aimed to evaluate the validity and
feasibility of 2 novel simplified scales (Simplified Faces Pain Scale, S-FPS; Simplified
Concrete Ordinal Scale, S-COS) for preschool-aged children. These simplified scales
used a 2-step self-report method: children were first asked whether they have pain
(yes/no); only if yes, then pain intensity was self-reported using a 3-point scale
with visual aids signifying mild/moderate/severe. We recruited 180 3- to 6-year-old
children undergoing routine blood collection. Each child was randomly assigned 2 of
3 scales—S-FPS, S-COS, Faces Pain Scale-Revised (FPS-R)—to self-report pain before
venipuncture, immediately after, and 5 minutes later, using both scales at each time-point.
Pain was also assessed using observation (Face Legs Activity Cry Consolability) at
each time point. The ability to discriminate pain from no pain was improved with S-FPS
and S-COS, compared with the FPS-R, among 4-year-olds, but not 3-year-olds. Correlation
with Face Legs Activity Cry Consolability was moderate to strong and cooperation rates
were similar for all self-report scales. The simplified scales can improve and simplify
pain assessment for 4-year-olds. Quantitative pain rating remains challenging for
3-year-olds.
Perspective
This study evaluated 2 novel simplified pain assessment tools for preschool-aged children undergoing
blood sampling. These scales demonstrated good validity and feasibility compared with
the FPS-R, suggesting these simplified pain scales may have a role in clinical practice
for children as young as 4 years.
Key words
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Article info
Publication history
Published online: January 06, 2017
Accepted:
December 27,
2016
Received in revised form:
December 15,
2016
Received:
July 20,
2016
Footnotes
This work was supported in part by the Child and Family Research Institute Summer Student Research Program, Vancouver, British Columbia, Canada.
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2017 by the American Pain Society
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- ErrataThe Journal of PainVol. 19Issue 4
- PreviewIn the article “Validity of Simplified Versus Standard Self-Report Measures of Pain Intensity in Preschool-Aged Children Undergoing Venipuncture,” published in the May 2017 issue (Journal of Pain 2017;18:564–573), the headings were incorrectly labeled in Table 1. The correct headings are “T1 T1 T1 T2 T2 T2 T3 T3 T3”. The amended table is presented below.
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