Development and validation of the Asian version of the oucher: a pain intensity scale for children

The present study was designed to develop and test the validity of the Asian version of the Oucher pain intensity scale, with color photographs of Taiwanese children as the pain intensity cues. A series of 3 studies were conducted. The aim of the first study was to create male and female versions of the Asian Oucher poster. Each poster consisted of 6 color photographs of children's faces, ranging from "no hurt at all" (scored as 0) to the "biggest hurt you could ever have" (scored as 5). In the second study, 220 children aged 3 to 6 years were recruited to examine the content validity. Children who were able to complete a Piagetian seriation task were asked to choose the sequence of 6 photographs. Photo sequences were adjusted according to the study findings. The third study was conducted to examine the convergent, discriminate, and clinical validity for children who are at different levels of pain intensity. In total, 111 children aged 3 to 10 years old who were experiencing surgical pain were recruited. The construct validity of the Asian Oucher was supported.

This study developed an Asian version of Oucher, with photographs of facial expressions of real Taiwanese children who were experiencing pain. The Asian Oucher can assess pain for children as young as 3 years old.