A review of pain measures for hospitalized children with cognitive impairment

Area of Science:

• Pediatric Pain Management
• Clinical Assessment Tools
• Child Psychology

Background:

• Assessing pain in non-verbal children with cognitive impairment presents significant challenges in acute care.
• Reliable and valid pain measures are crucial for effective treatment and patient outcomes.
• Existing literature lacks a comprehensive review of pain assessment tools for this vulnerable population.

Purpose of the Study:

• To systematically review pain measures for hospitalized children with cognitive impairment who cannot self-report.
• To evaluate the psychometric properties and clinical utility of selected pain assessment tools.
• To identify the most feasible and effective pain measures for acute care settings.

Main Methods:

• Conducted electronic searches to identify relevant published evidence.
• Reviewed studies examining the psychometrics and feasibility of four pain measures: Non-Communicating Child's Pain Checklist-Postoperative Version, Individualized Numeric Rating Scale, Pediatric Pain Profile, and revised Face, Leg, Activity, Cry, and Consolability scale.
• Analyzed reported validity, reliability, and feasibility data.

Main Results:

• All four reviewed pain measures demonstrated established validity and reliability.
• Variability was observed in the clinical utility findings across the different measures.
• The revised Face, Leg, Activity, Cry, and Consolability scale exhibited strong feasibility in acute care settings.

Conclusions:

• The revised Face, Leg, Activity, Cry, and Consolability scale is a valid, reliable, and feasible option for assessing pain in non-verbal children with cognitive impairment in acute care.
• While other measures possess good psychometric properties, their clinical utility may be more variable.
• Further research may explore optimizing the implementation of these tools in diverse clinical environments.