Highlights
- •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.
Abstract
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.
Perspective
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.
Key words
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References
- The assessment and management of acute pain in infants, children, and adolescents.Pediatrics. 2001; 108: 793-797
- Development and preliminary validation of a postoperative pain measure for parents.Pain. 1996; 68: 307-313
- Prevalence and source of pain in pediatric inpatients.Pain. 1996; 68: 25-31
- 2004 National Hospital Discharge Survey.Adv Data. 2006; : 1-19
- Validity and responsiveness of the pediatric quality of life inventory (PedsQL) 4.0 generic core scales in the pediatric inpatient setting.JAMA Pediatr. 2014; 168: 1114-1121
- Scale development: Theory and applications.J Educ Meas. 1991; 31: 79-82
- PROMIS pediatric self-report scales distinguish subgroups of children within and across six common pediatric chronic health conditions.Qual Life Res. 2015; 24: 2195-2208
- Prevalence of moderate-severe pain in hospitalized children.Paediatr Anaesth. 2012; 22: 661-668
- Comparisons of five health status instruments for orthopedic evaluation.Med Care. 1990; 28: 632-642
- Core outcome domains and measures for pediatric acute and chronic/recurrent pain clinical trials: PedIMMPACT recommendations.J Pain. 2008; 9: 771-783
- The development of a paediatric quality of life questionnaire to measure post-operative pain following tonsillectomy.Int J Pediatr Otorhinolaryngol. 1998; 44: 115-123
- Validation of the numerical rating scale for pain intensity and unpleasantness in pediatric acute postoperative pain: Sensitivity to change over time.J Pain. 2012; 13: 359-369
- Identification of pain-related psychological risk factors for the development and maintenance of pediatric chronic postsurgical pain.J Pain Res. 2013; 6: 167-180
- Development and validation of the Child Activity Limitations Interview: A measure of pain-related functional impairment in school-age children and adolescents.Pain. 2004; 109: 461-470
- JCAHO pain management standards are unveiled. Joint Commission on Accreditation of Healthcare Organizations.JAMA. 2000; 284: 428-429
- Pain and health-related quality of life after pediatric inpatient surgery.J Pain. 2015; 16: 1334-1341
- Trajectories of postsurgical pain in children: Risk factors and impact of late pain recovery on long-term health outcomes after major surgery.Pain. 2015; 156: 2383-2389
- Pediatric medical complexity algorithm: A new method to stratify children by medical complexity.Pediatrics. 2014; 133: e1647-e1654
- Pain in hospitalized children: A prospective cross-sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital.Pain Res Manag. 2008; 13: 25-32
- The PedsQL 4.0 as a pediatric population health measure: Feasibility, reliability, and validity.Ambul Pediatr. 2003; 3: 329-341
- PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations.Med Care. 2001; 39: 800-812
- Development and validation of the Youth Acute Pain Functional Ability Questionnaire (YAPFAQ).J Pain. 2014; 15: 1319-1327
Article info
Publication history
Published online: May 30, 2017
Accepted:
May 5,
2017
Received in revised form:
April 25,
2017
Received:
January 10,
2017
Footnotes
Jennifer A. Rabbitts is supported by Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under award K23HD078239; Rachel V. Aaron is supported by T32GM086270; Tonya M. Palermo is supported by National Institutes of Health K24HD060068.
The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2017 Published by Elsevier Inc. on behalf of the American Pain Society
