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A Protocol of Manual Tests to Measure Sensation and Pain in Humans
Published on: December 19, 2016
A comparison of three scales for measuring pain in children with cognitive impairment
Marta Massaro1, Luca Ronfani2, Giovanna Ferrara1
1University of Trieste, Trieste, Italy.
Insights
The Non-Communicating Children's Pain Checklist Postoperative Version (NCCPC-PV) is the easiest and most appropriate pain scale for children with cognitive impairments. This validated tool should be adopted in clinical practice for accurate pain assessment.
Area of Science:
- Pediatric Pain Management
- Developmental Psychology
- Clinical Assessment Tools
Background:
- Pain assessment in children with cognitive impairments is challenging and often neglected.
- Limited research compares the clinical utility of specialized pain scales for this population.
- Existing scales may not adequately capture pain experiences in non-communicative children.
Purpose of the Study:
- To compare the clinical effectiveness of three pain assessment scales: the Non-Communicating Children's Pain Checklist Postoperative Version (NCCPC-PV), the Echelle Douleur Enfant San Salvador (DESS), and the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS).
- To evaluate inter-rater agreement, correlation, behavioral dependence, simplicity, and caregiver adequacy of each scale.
- To identify the most suitable scale for routine pain assessment in children with cognitive impairments.
Main Methods:
- A study involving 40 children with cognitive impairments was conducted.
- External observers and caregivers assessed pain levels using NCCPC-PV, DESS, and CHEOPS.
- Key metrics included inter-rater agreement, scale correlation, and ease of use.
Main Results:
- The NCCPC-PV and DESS demonstrated a strong correlation (Spearman's rho = 0.76), outperforming correlations with CHEOPS.
- While DESS had better inter-rater agreement, it required greater familiarity with the child and was perceived as more complex.
- The NCCPC-PV was rated as the simplest and most appropriate scale for pain assessment by caregivers.
Conclusions:
- The NCCPC-PV is the most user-friendly and appropriate scale for assessing pain in children with cognitive impairments.
- Clinical settings should consider adopting the NCCPC-PV for improved pain management in this vulnerable population.
- Further research may explore long-term impacts of using NCCPC-PV in clinical practice.
Aim:
Pain is a neglected problem in children with cognitive impairments, and few studies compare the clinical use of specific pain scales. We compared the Non-Communicating Children's Pain Checklist Postoperative Version (NCCPC-PV), the Echelle Douleur Enfant San Salvador (DESS) and the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS). The first two were developed for children with cognitive impairment, and the third is a more general pain scale.
Methods:
Two external observers and the child's caregiver assessed 40 children with cognitive impairment for pain levels. We assessed inter-rater agreement, correlation, dependence on knowledge of the child's behaviour, simplicity and adequacy in pain rating according to the caregiver for all three scales.
Results:
The correlation between the NCCPC-PV and the DESS was strong (Spearman correlation coefficient = 0.76) and better than between each scale and the CHEOPS. Although the DESS showed better inter-rater agreement, it was more dependent on familiarity with the child and was judged more difficult to use by all observers. The NCCPC-PV was the easiest use and the most appropriate for rating the child's pain.
Conclusion:
The NCCPC-PV was the easiest to use for pain assessment in cognitively impaired children and should be adopted in clinical settings.
