Original Report| Volume 18, ISSUE 10, P1209-1215, October 2017

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Validation of the Youth Acute Pain Functional Ability Questionnaire in Children and Adolescents Undergoing Inpatient Surgery

  • Jennifer A. Rabbitts
    Address reprint requests to Jennifer A. Rabbitts, MB, ChB, Seattle Children's Hospital, 4800 Sand Point Way NE, MB.11.500.3, Seattle, WA 98105.
    Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington

    Center for Clinical and Translational Research, Seattle Children's Hospital, Seattle, Washington
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  • Rachel V. Aaron
    Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington

    Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington
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  • William T. Zempsky
    Division of Pain and Palliative Medicine, Connecticut Children's Medical Center, Hartford, Connecticut
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  • Tonya M. Palermo
    Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington

    Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington
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      • The Youth Acute Pain Functional Ability Questionnaire (YAPFAQ) was evaluated.
      • The YAPFAQ showed good psychometric properties in youth after inpatient surgery.
      • The YAPFAQ showed good responsiveness to expected recovery.
      • The YAPFAQ-3 short form showed promising psychometric properties.


      Half of children admitted after surgery experience intense pain in hospital, and many experience continued pain and delayed functional recovery at home. However, there is a gap in tools available to measure acute functional ability in pediatric postsurgical settings. We aimed to validate the Youth Acute Pain Functional Ability Questionnaire (YAPFAQ) in a large inpatient pediatric surgical population, evaluate its responsiveness to expected functional recovery, and develop a short form for broad clinical implementation. The YAPFAQ is a self-report measure assessing acute functional ability, developed in children admitted for acute sickle cell pain. We evaluated psychometric properties of the measure in 564 children ages 8 to 18 years admitted after surgery. A sample of 54 participants completed the YAPFAQ daily for 3 days after major surgery to assess responsiveness. The measure showed good reliability (Cronbach α = .96) and construct validity, with expected relationships with physical health-related quality of life (r = −.53, P < .001) and pain intensity (r = .42, P < .001). YAPFAQ scores decreased over time showing good responsiveness to expected recovery. A 3-item short form of the YAPFAQ showed promising psychometric properties. Early assessment of functioning after surgery may identify children at risk for poor functional outcomes and allow targeting of therapies to improve postsurgical recovery.


      The YAPFAQ showed promising psychometric properties in a pediatric postsurgical population. This study addresses a gap in tools available to monitor functional recovery during hospitalization after pediatric surgery. Early detection of problems with recovery may enable targeted therapies to improve postsurgical outcomes.

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