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Validating the Derbyshire Children's Hospital Pain Tool: a pilot study
Vanessa Peden1, Mair Vater, Imti Choonara
1Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Uttoxeter Road, Derby DE22 3NE, UK. vanessa.peden@nottingham.ac.uk
Insights
The Derbyshire Children's Hospital Paediatric Pain Chart (DPC) is a reliable tool for assessing postoperative pain in young children. This study validates its use in children aged 1-5 years undergoing surgery.
Area of Science:
- Pediatric Pain Management
- Clinical Assessment Tools
Background:
- The Derbyshire Children's Hospital Paediatric Pain Chart (DPC) is utilized for pain assessment in pediatric patients.
- It is designed for children of all ages in postoperative settings, incorporating facial expression, body movement, and verbalization.
- An exploratory study was conducted to determine the reliability and validity of the DPC.
Purpose of the Study:
- To evaluate the reliability and validity of the Derbyshire Children's Hospital Paediatric Pain Chart (DPC).
- To assess the DPC's suitability as a pain assessment tool for young children undergoing surgery.
Main Methods:
- A research nurse assessed 40 children aged 1-5 years undergoing minor/intermediate surgery.
- Pain was assessed using both the Toddler Preschooler Postoperative Pain Scale and the DPC, preoperatively and for 4 hours postoperatively.
- Analgesia administered was recorded, and inter-rater reliability was assessed between the research nurse and nursing staff.
Main Results:
- The DPC demonstrated known groups validity, with all children scoring 0 preoperatively.
- Strong correlation (r=0.89) indicated convergent validity between the DPC and another pain scale.
- High inter-rater reliability (Spearman's rho=0.81) and Cronbach's alpha (0.83-0.98) supported the DPC's consistency.
- Construct validity was shown by a significant decrease in pain scores after analgesia administration.
Conclusions:
- The Derbyshire Children's Hospital Paediatric Pain Chart (DPC) is a reliable pain assessment tool.
- The DPC demonstrates construct, convergent, and known groups validity for children aged 1-5 years.
- The DPC is suitable for assessing pain in pediatric patients undergoing minor and intermediate surgery.
Background:
The Derbyshire Children's Hospital Paediatric Pain Chart (DPC) is the current pain assessment tool used at the Derbyshire Children's Hospital. It was originally devised as a simple pain tool for use in the clinical area, and it is applicable for use in children of all ages within the postoperative setting. The pain assessment chart encompasses pain assessment by utilizing facial expression, body movement and verbal expression. An exploratory study was performed to define its reliability and validity.
Methods:
The research nurse (V.P.) assessed 40 children aged 1-5 undergoing minor and intermediate surgery comparing the Toddler Preschooler Postoperative Pain Scale and the DPC. Assessments were performed preoperatively and for 4 h postoperatively. Any analgesia administered postoperatively was recorded.
Results:
All the children scored 0 preoperatively with both pain scales, thus demonstrating known groups validity. There were 116 dual assessments by the research nurse using both pain scales. There was a strong correlation (r = 0.89) demonstrating convergent validity. There was a significant correlation between 182 joint assessments by the research nurse (V.P.) and the nursing staff using the DPC (Spearmans rank correlation, 0.81) and the Cronbach alpha coefficient ranged from 0.83 to 0.98. Construct validity was demonstrated by a fall in the mean pain scores from 1.8 to 0.1 following analgesia in 19 children.
Conclusions:
This exploratory study suggests the DPC holds construct, convergent and known groups validity and is a reliable pain assessment tool for children aged 1-5 years undergoing minor and intermediate surgery.