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Cross-validation of a self-report scale for postoperative pain in school-aged children
Suwannee Suraseranivongse1, Thunyanit Montapaneewat, Jitprapa Manon
1Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. suwannee_18@hotmail.com
Insights
This study validated four pain scales for Thai children. The Facial Expression Scale (FACES) demonstrated reliability and validity, making it a practical choice for assessing pediatric pain.
Area of Science:
- Pediatric Pain Assessment
- Psychometrics in Children
- Cross-Cultural Validation Studies
Background:
- Accurate pain assessment in children is crucial for effective management.
- Existing self-report pain scales require validation in diverse pediatric populations.
- The Facial Expression Scale (FACES) is a commonly used tool, but its psychometric properties need rigorous evaluation.
Purpose of the Study:
- To cross-validate four self-report pain scales: Verbal Rating Scale (VRS), Facial Expression Scale (FACES), Color Analogue Scale (CAS), and Poker Chip Tool (PCT) in Thai children aged 5-12 years.
- To assess the concordance of these self-report measures with an observational pain scale, the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS).
- To determine the most reliable, valid, and preferred pain assessment tool for this population.
Main Methods:
- Cross-validation study involving 100 students for test-retest reliability and 87 patients for validity assessments.
- Utilized Verbal Rating Scale (VRS), Facial Expression Scale (FACES), Color Analogue Scale (CAS), and Poker Chip Tool (PCT) for self-report.
- Compared self-report measures against the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) for observational concordance.
Main Results:
- All self-report measures exhibited moderate to good test-retest reliability (Kappa = 0.501-0.712).
- The Facial Expression Scale (FACES) demonstrated acceptable face validity (IC > 0.5) and was the most preferred scale among participants.
- Agreement between self-report scales and CHEOPS was significantly higher in younger children (5-8 years) compared to older children (9-12 years).
Conclusions:
- The Facial Expression Scale (FACES) is a valid, reliable, and practical tool for assessing pain in Thai children.
- Self-report pain measures show better agreement with observational assessments in younger children (5-8 years) than in older children (9-12 years).
- Findings support the use of FACES as a preferred method for pediatric pain evaluation in this cultural context.
Abstract:
The present study cross-validated self-report pain scales: Verbal Rating Scale (VRS), Facial Expression Scale (FACES), Color Analogue Scale (CAS) and Poker Chip Tool (PCT) in Thai children aged 5-12 years. The concordance with observational measure, Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) was also tested. Among 100 students, test-retest reliability of all self-report measures was moderate to good (K = 0.501-0.712) and only FACES yielded acceptable face validity(IC > 0.5). Validation in 87 patients, all scales showed construct and concurrent validity. FACES was the most preferred scale. Agreement of self-report measures and CHEOPS was better in the age group 5-8 years (K = 0.417-0.826) than 9-12 years (K = 0.231-0.529). In conclusion, FACES is a valid, reliable and practical tool. Self-report measures are more in concordance with CHEOPS in the younger age group.