Verifying the validity and reliability of the Japanese version of the Face, Legs, Activity, Cry, Consolability...

Area of Science:

• Pediatric Pain Assessment
• Clinical Psychology
• Nursing Research

Background:

• Preverbal pediatric patients cannot self-report pain intensity, necessitating validated observational tools.
• The Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale is a widely used benchmark for pediatric pain evaluation.
• The FLACC scale's unavailability in Japanese has limited its use in Japanese healthcare settings.

Purpose of the Study:

• To translate the FLACC Behavioral Scale into Japanese.
• To verify the validity and reliability of the Japanese version of the FLACC Behavioral Scale for pediatric pain assessment.

Main Methods:

• The FLACC scale was translated into Japanese via back-translation by eight medical researchers.
• A clinical study involving 24 pediatric patients in an intensive care unit was conducted.
• Validity was assessed using weighted kappa coefficients and intraclass correlation coefficients; reliability was evaluated through correlation analysis with the visual analog scale (VAS obs).

Main Results:

• The translation was approved by the original FLACC scale author.
• High inter-observer agreement was found for all FLACC categories and the total score (κ ranging from 0.74 to 0.95).
• A strong criterion validity was demonstrated between the Japanese FLACC scale and VAS obs (r = 0.96).

Conclusions:

• The Japanese version of the FLACC Behavioral Scale demonstrates high validity and reliability.
• This validated tool can now be effectively utilized for pediatric pain assessment in Japanese hospitals.
• The availability of this scale will improve pain management for non-verbal pediatric patients in Japan.