Related Experiment Video
Updated: Aug 1, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 28, 2010
Comparison of three preverbal scales for postoperative pain assessment in a diverse pediatric sample
J G Schade1, B A Joyce, J Gerkensmeyer
1Department of Nursing, Indiana University Medical Center, Indianapolis 46202-5250, USA.
Insights
This study found three pain scales—Riley Infant Pain Scale (RIPS), Nursing Assessment of Pain Intensity (NAPI), and Postoperative Pain Score (POPS)—are reliable for assessing pain in young children. RIPS and NAPI showed lower caregiver burden.
Area of Science:
- Pediatric Nursing
- Pain Management
- Clinical Assessment
Background:
- Accurate pain assessment in preverbal and nonverbal children is crucial for effective pain management.
- Existing pain scales require rigorous evaluation for reliability and validity across diverse pediatric populations.
- Identifying appropriate pain assessment tools is essential for infants and young children with varying developmental and cognitive abilities.
Purpose of the Study:
- To compare the reliability and validity of three pain measurement scales: Riley Infant Pain Scale (RIPS), Nursing Assessment of Pain Intensity (NAPI), and Postoperative Pain Score (POPS).
- To determine the most appropriate scale for clinical use in evaluating pain in infants and young children, irrespective of developmental stage or disability.
Main Methods:
- Utilized purposive sampling of 391 postoperative infants and children in a midwestern children's hospital.
- Conducted four assessments with each scale, 1 hour apart, by trained observers blinded to medication.
- Employed rigorous data analysis to evaluate inter-rater reliability and discriminative ability of the scales.
Main Results:
- All three scales demonstrated high inter-rater reliability.
- The scales showed satisfactory ability to discriminate between pain and no-pain observations.
- Riley Infant Pain Scale (RIPS) and Nursing Assessment of Pain Intensity (NAPI) presented a lower caregiver burden compared to Postoperative Pain Score (POPS).
Conclusions:
- The revised Riley Infant Pain Scale (RIPS), Nursing Assessment of Pain Intensity (NAPI), and Postoperative Pain Score (POPS) are reliable and valid tools for pediatric pain assessment.
- RIPS and NAPI are particularly suitable for clinical settings due to their acceptable psychometric properties and reduced caregiver burden.
- These findings support the use of RIPS and NAPI for consistent and effective pain management in nonverbal and preverbal pediatric patients.
Abstract:
The purposes of this study were to compare the reliability and validity of three pain measurement scales for assessing pain in preverbal and nonverbal children and to determine which of the scales was most appropriate in a clinical setting to evaluate pain for infants and young children regardless of developmental stage or cognitive or physical disability. Pain scales tested were revised versions of the Riley Infant Pain Scale (RIPS), the Nursing Assessment of Pain Intensity (NAPI), and the Postoperative Pain Score (POPS). Purposive sampling of 391 postoperative infants and children was used for evaluation of pain in a midwestern children's hospital. Four assessments with each scale were done 1 hr apart by trained observers blinded to pain medications. Data analyses supported high inter-rater reliability, satisfactory discrimination between pain and no-pain observations, and suggested acceptability for all three scales with lower caregiver burden for RIPS and NAPI.
