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Psychometric properties of the non-communicating children's pain checklist-revised
Lynn M Breau1, Patrick J McGrath, Carol S Camfield
1Department of Psychology, Dalhousie University and Pediatric Pain Research Lab, IWK Health Centre, 5850 University Avenue, Halifax, Nova Scotia, Canada B3J 3G9. lbreau@ns.sympatico.ca
Insights
The revised Non-Communicating Children's Pain Checklist (NCCPC-R) accurately measures pain in children with severe cognitive impairments. This validated tool offers reliable pain assessment for non-verbal pediatric populations.
Area of Science:
- Pediatric Pain Assessment
- Child Psychology
- Clinical Psychometrics
Background:
- The Non-Communicating Children's Pain Checklist (NCCPC) showed initial promise for assessing pain in children with severe cognitive impairments.
- A need existed to further validate and refine this tool with a larger sample size.
Purpose of the Study:
- To evaluate the psychometric properties of a revised version of the NCCPC (NCCPC-R).
- To establish the reliability and validity of the NCCPC-R for pain measurement in children with severe cognitive impairments.
Main Methods:
- Caregivers of 71 children (aged 3-18) with severe cognitive impairments used the NCCPC-R during painful and non-painful periods.
- 55 caregivers completed a second set of observations for inter-rater reliability.
- Psychometric properties including internal consistency, validity, reliability, sensitivity, and specificity were analyzed.
Main Results:
- The NCCPC-R demonstrated excellent internal consistency and reliability over time.
- Scores on the NCCPC-R were significantly related to caregiver-reported pain intensity.
- Receiver operating characteristic curves indicated a score of 7 or higher on the NCCPC-R suggests pain, with 84% sensitivity and 77% specificity.
Conclusions:
- The revised Non-Communicating Children's Pain Checklist (NCCPC-R) possesses strong psychometric properties.
- The NCCPC-R is a valid and reliable tool for assessing pain in children with severe cognitive impairments.
- A cutoff score of 7 on the NCCPC-R can effectively identify pain in this population.
Abstract:
The non-communicating children's pain checklist (NCCPC) has displayed preliminary validity and reliability for measuring pain in children with severe cognitive impairments (Dev Med Child Neurol 42 (2000) 609). This study provides evidence of the psychometric properties of a revised NCCPC (NCCPC-R) with a larger cohort of children. Caregivers of 71 children with severe cognitive impairments (aged 3-18) conducted observations of their children using the NCCPC-R during a time of pain and a time without pain. Fifty-five caregivers completed a second set of observations. The score results on the NCCPC-R were: internally consistent, significantly related to pain intensity ratings provided by caregivers, consistent over time, sensitive to pain, and specific to pain. Analyses of children's individual scores indicated up to 95% of their scores were consistent. Receiver operating characteristic curves suggest a score of 7 or greater on the NCCPC-R as indicative of pain in children with cognitive impairments, with 84% sensitivity and up to 77% specificity. These results provide evidence of NCCPC-R having excellent psychometric properties.