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Development and preliminary psychometric testing of the Multidimensional Assessment of Pain Scale: MAPS
Anne-Sylvie Ramelet1, Nancy Rees, Susan McDonald
1Women's & Children's Health Service, Nursing Research, Perth, Australia. anne-sylvie.ramelet@health.wa.gov.au
Insights
The Multidimensional Assessment Pain Scale (MAPS) shows promising preliminary psychometric properties for assessing pain in critically ill preverbal children. Further testing is ongoing to confirm its reliability and validity in clinical settings.
Area of Science:
- Pediatric critical care medicine
- Pain assessment in infants and children
Background:
- Postoperative pain assessment in critically ill preverbal children presents unique challenges.
- The Multidimensional Assessment Pain Scale (MAPS) was developed to address this clinical need.
Purpose of the Study:
- To evaluate the preliminary psychometric properties of the MAPS.
- To establish the validity and reliability of MAPS for assessing pain in young children.
Main Methods:
- MAPS was developed based on observed pain indicators in postoperative infants.
- Content validity was confirmed by expert consensus.
- The scale's validity and reliability were tested in 43 postoperative children (0-31 months) in pediatric intensive care units.
- Concurrent and convergent validity were assessed by comparing MAPS with FLACC and VAS scales.
Main Results:
- MAPS demonstrated moderate internal consistency (r = 0.68).
- Good to excellent interrater reliability was found for MAPS categories (kappa: 0.68-0.84) and total score (ICC: 0.91).
- Small measurement error was observed when comparing MAPS with FLACC and VAS.
Conclusions:
- The MAPS shows promising initial psychometric properties for assessing pain in critically ill preverbal children.
- Further psychometric evaluation, including responsiveness to analgesia, is warranted.
Background:
This study aimed to test the preliminary psychometric properties of the Multidimensional Assessment Pain Scale (MAPS), a clinical instrument developed for assessing postoperative pain in critically ill preverbal children.
Methods:
The MAPS was developed using pain indicators observed in postoperative critically ill infants. Content validity was established by a panel of experts. The scale was tested for validity and reliability in 43 postoperative children aged 0-31 months admitted to the pediatric intensive care units of two tertiary referral hospitals. Pain was measured concurrently by three independent assessors using the MAPS, the Face, Leg, Activity, Cry, and Consolability scale (FLACC) and the Visual Analog Scale (VAS) to assess concurrent and convergent validity.
Results:
Internal consistency was moderate (r = 0.68). Interrater reliability of the MAPS was good (kappa: 0.68-0.84) for all categories and moderate for breathing pattern (kappa = 0.54). Excellent interrater reliability was shown for total MAPS (intraclass correlation 0.91). Agreement measurements between MAPS and FLACC, and MAPS and VAS showed that the risk of measurement error was small.
Conclusion:
Although initial psychometric testing of the MAPS shows promising results, the tool requires further psychometric testing, including responsiveness to analgesic effect (currently in progress).
