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Jennifer Stinson - One of the best experts on this subject based on the ideXlab platform.
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recommendations for selection of self report Pain intensity measures in children and adolescents a systematic review and quality assessment of measurement properties
Pain, 2019Co-Authors: Kathryn A Birnie, Amos S Hundert, Chitra Lalloo, Cynthia Nguyen, Jennifer StinsonAbstract:In 2006, Pain published a systematic review of the measurement properties of self-report Pain intensity measures in children and adolescents (Stinson JN, Kavanagh T, Yamada J, Gill N, Stevens B. Systematic review of the psychometric properties, interpretability and feasibility of self-report Pain intensity measures for use in clinical trials in children and adolescents. Pain 2006;125:143-57). Key developments in pediatric Pain necessitate an update of this work, most notably growing use of the 11-point numeric rating Scale (NRS-11). Our aim was to review the measurement properties of single-item self-report Pain intensity measures in children 3 to 18 years old. A secondary aim was to develop evidence-based recommendations for measurement of child and adolescent self-report of acute, postoperative, and chronic Pain. Methodological quality and sufficiency of measurement properties for reliability, validity, responsiveness, and interpretability was assessed by at least 2 investigators using COnsensus based Standards for the selection of health Measurement INstruments (COSMIN). Searches identified 60 unique self-report measures, of which 8 (reported in 80 papers) met inclusion criteria. Well-established measures included the NRS-11, Color Analogue Scale (CAS), Faces Pain Scale-Revised (FPS-R; and original FPS), Pieces of Hurt, Oucher-Photographic and Numeric Scales, Visual Analogue Scale, and Wong-Baker Faces Pain Rating Scale (Faces). Quality of studies ranged from poor to excellent and generally reported sufficient criterion and construct validity, and responsiveness, with variable reliability. Content and cross-cultural validity were minimally assessed. Based on available evidence, the NRS-11, FPS-R, and CAS were strongly recommended for self-report of acute Pain. Only weak recommendations could be made for self-report measures for postoperative and chronic Pain. No measures were recommended for children younger than 6 years, identifying a need for further measurement refinement in this age range. Clinical practice and future research implications are discussed.
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validation of the numerical rating Scale for Pain intensity and unpleasantness in pediatric acute postoperative Pain sensitivity to change over time
The Journal of Pain, 2012Co-Authors: Gabrielle M Page, Jennifer Stinson, Joel Katz, Lisa Isaac, Andrea L Martinpichora, Fiona CampbellAbstract:Abstract This study evaluates the construct validity (including sensitivity to change) of the numerical rating Scale (NRS) for Pain intensity (I) and unpleasantness (U) and participant Pain Scale preferences in children/adolescents with acute postoperative Pain. Eighty-three children aged 8 to 18 years (mean = 13.8, SD = 2.4) completed 3 Pain Scales including NRS, Verbal Rating Scale (VRS), and Faces Scales (Faces Pain Scale-Revised [FPS-R] and Facial Affective Scale [FAS], respectively) for Pain intensity (I) and unpleasantness (U) 48 to 72 hours after major surgery, and the NRS, VRS and Functional Disability Index (FDI) 2 weeks after surgery. As predicted, the NRSI correlated highly with the VRSI and FPS-R and the NRSU correlated highly with the VRSU and FAS 48 to 72 hours after surgery. The FDI correlated moderately with the NRS at both time points. Scores on the NRSI and NRSU at 48 to 72 hours were significantly higher than at 2 weeks after surgery. Children found the Faces Scales the easiest to use while the VRS was liked the least and was the hardest to use. The NRS has adequate evidence of construct validity including sensitivity for both Pain intensity and unpleasantness. This study further supports the validity of the NRS as a tool to measure both intensity and unpleasantness of acute Pain in children. Perspective This article evaluates the construct validity including sensitivity of the Numerical Rating Scale for Pain intensity and Pain unpleasantness over time in children after major surgery. The NRS could be used by clinicians to assess these 2 different dimensions of children’s Pain experience in acute Pain settings.
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a systematic review of Faces Scales for the self report of Pain intensity in children
Pediatrics, 2010Co-Authors: Deborah Tomlinson, Jennifer Stinson, Carl L Von Baeyer, Lillian SungAbstract:CONTEXT: Numerous Faces Scales have been developed for the measurement of Pain intensity in children. It remains unclear whether any one of the Faces Scales is better for a particular purpose with regard to validity, reliability, feasibility, and preference. OBJECTIVES: To summarize and systematically review Faces Pain Scales most commonly used to obtain self-report of Pain intensity in children for evaluation of reliability and validity and to compare the Scales for preference and utility. METHODS: Five major electronic databases were systematically searched for studies that used a Faces Scale for the self-report measurement of Pain intensity in children. Fourteen Faces Pain Scales were identified, of which 4 have undergone extensive psychometric testing: Faces Pain Scale (FPS) (scored 0–6); Faces Pain Scale–Revised (FPS-R) (0–10); Oucher Pain Scale (0–10); and Wong-Baker Faces Pain Rating Scale (WBFPRS) (0–10). These 4 Scales were included in the review. Studies were classified by using psychometric criteria, including construct validity, reliability, and responsiveness, that were established a priori. RESULTS: From a total of 276 articles retrieved, 182 were screened for psychometric evaluation, and 127 were included. All 4 Faces Pain Scales were found to be adequately supported by psychometric data. When given a choice between Faces Scales, children preferred the WBFPRS. Confounding of Pain intensity with affect caused by use of smiling and crying anchor Faces is a disadvantage of the WBFPRS. CONCLUSIONS: For clinical use, we found no grounds to switch from 1 Faces Scale to another when 1 of the Scales is in use. For research use, the FPS-R has been recommended on the basis of utility and psychometric features. Data are sparse for children below the age of 5 years, and future research should focus on simplified measures, instructions, and anchors for these younger children.
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measurement of self reported Pain intensity in children and adolescents
Journal of Psychosomatic Research, 2010Co-Authors: Anna Huguet, Jennifer Stinson, Patrick J McgrathAbstract:Acute and chronic Pain is a common experience in children and youth. A thorough assessment is fundamental to understand this experience and to assess and monitor treatment responses. The intensity of Pain is the parameter most commonly assessed. In this article, we describe the different methods employed to assess pediatric Pain intensity and review well-validated and commonly used self-report measures of Pain. This review is based on the recent systematic reviews conducted for the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials Consensus Group and the Society of Pediatric Psychology. Amongst the several types of pediatric Pain measures, self-report, when available, is regarded as the primary source of information about Pain intensity, to be complemented by observation and knowledge of the context. There is a large number of self-report measures of pediatric Pain intensity; and there is some agreement that professionals in the clinical and research practice should assess Pain intensity using the Pieces of Hurt Tool, the Faces Pain Scale, the Oucher, or Visual Analogue Scales because these measures have shown to have sound psychometric properties and clinical utility. Despite the increased number of age-appropriate self-report measures of pediatric Pain intensity over the last years, we report several research gaps and priorities of future research.
Carl L Von Baeyer - One of the best experts on this subject based on the ideXlab platform.
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a systematic review of Faces Scales for the self report of Pain intensity in children
Pediatrics, 2010Co-Authors: Deborah Tomlinson, Jennifer Stinson, Carl L Von Baeyer, Lillian SungAbstract:CONTEXT: Numerous Faces Scales have been developed for the measurement of Pain intensity in children. It remains unclear whether any one of the Faces Scales is better for a particular purpose with regard to validity, reliability, feasibility, and preference. OBJECTIVES: To summarize and systematically review Faces Pain Scales most commonly used to obtain self-report of Pain intensity in children for evaluation of reliability and validity and to compare the Scales for preference and utility. METHODS: Five major electronic databases were systematically searched for studies that used a Faces Scale for the self-report measurement of Pain intensity in children. Fourteen Faces Pain Scales were identified, of which 4 have undergone extensive psychometric testing: Faces Pain Scale (FPS) (scored 0–6); Faces Pain Scale–Revised (FPS-R) (0–10); Oucher Pain Scale (0–10); and Wong-Baker Faces Pain Rating Scale (WBFPRS) (0–10). These 4 Scales were included in the review. Studies were classified by using psychometric criteria, including construct validity, reliability, and responsiveness, that were established a priori. RESULTS: From a total of 276 articles retrieved, 182 were screened for psychometric evaluation, and 127 were included. All 4 Faces Pain Scales were found to be adequately supported by psychometric data. When given a choice between Faces Scales, children preferred the WBFPRS. Confounding of Pain intensity with affect caused by use of smiling and crying anchor Faces is a disadvantage of the WBFPRS. CONCLUSIONS: For clinical use, we found no grounds to switch from 1 Faces Scale to another when 1 of the Scales is in use. For research use, the FPS-R has been recommended on the basis of utility and psychometric features. Data are sparse for children below the age of 5 years, and future research should focus on simplified measures, instructions, and anchors for these younger children.
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postoperative self report of Pain in children interScale agreement response to analgesic and preference for a Faces Scale and a visual analogue Scale
Pain Research & Management, 2010Co-Authors: Clement De Tovar, Carl L Von Baeyer, Chantal Wood, Jeanpierre Alibeu, Malik Houfani, Charles ArvieuxAbstract:OBJECTIVE: To augment available validation data for the Faces Pain Scale – Revised (FPS-R) and to assess interScale agreement and preference in comparison with the Coloured Analogue Scale (CAS) in pediatric acute Pain.
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three new datasets supporting use of the numerical rating Scale nrs 11 for children s self reports of Pain intensity
Pain, 2009Co-Authors: Carl L Von Baeyer, Lara J Spagrud, Julia C Mccormick, Eugene Choo, Kathleen A Neville, Mark ConnellyAbstract:Despite wide usage of the Numerical Rating Scale (NRS) for self-report of Pain intensity in clinical practice with children and adolescents, validation data are lacking. We present here three datasets from studies in which the NRS was used together with another self-report Scale. Study A compared post-operative Pain ratings on the NRS with scores on the Faces Pain Scale-Revised (FPS-R) in 69 children age 7–17 years who had undergone a variety of surgical procedures. Study B compared post-operative Pain ratings on the NRS with scores on the Visual Analogue Scale (VAS) in 29 children age 9–17 years who had undergone pectus excavatum repair. Study C compared ratings of remembered immunization Pain in 236 children who comprised an NRS group and a sex- and age-matched VAS group. Correlations of the NRS with the FPS-R and VAS were r = 0.87 and 0.89 in Studies A and B, respectively. In Study C, the distributions of scores on the NRS and VAS were very similar except that scores closest to the no Pain anchor were more likely to be selected on the VAS than the NRS. The NRS can be considered functionally equivalent to the VAS and FPS-R except for very mild Pain (<1/10). We conclude that use of the NRS is tentatively supported for clinical practice with children of 8 years and older, and we recommend further research on the lower age limit and on standardized age-appropriate anchors and instructions for this Scale.
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the Faces Pain Scale revised toward a common metric in pediatric Pain measurement
Pain, 2001Co-Authors: Carrie L Hicks, Carl L Von Baeyer, Pamela A Spafford, Inez Van Korlaar, Belinda GoodenoughAbstract:Abstract The Faces Pain Scale (FPS; Bieri et al., Pain 41 (1990) 139) is a self-report measure used to assess the intensity of children's Pain. Three studies were carried out to revise the original Scale and validate the adapted version. In the first phase, the FPS was revised from its original seven Faces to six, while maintaining its desirable psychometric properties, in order to make it compatible in scoring with other self-rating and observational Scales which use a common metric (0–5 or 0–10). Using a computer-animated version of the FPS developed by Champion and colleagues (Sydney Animated Facial Expressions Scale), psychophysical methods were applied to identify four Faces representing equal intervals between the Scale values representing least Pain and most Pain. In the second phase, children used the new six-face Faces Pain Scale – Revised (FPS-R) to rate the intensity of Pain from ear piercing. Its validity is supported by a strong positive correlation (r=0.93, N=76) with a visual analogue Scale (VAS) measure in children aged 5–12 years. In the third phase, a clinical sample of pediatric inpatients aged 4–12 years used the FPS-R and a VAS or the colored analogue Scale (CAS) to rate Pain during hospitalization for surgical and non-surgical Painful conditions. The validity of the FPS-R was further supported by strong positive correlations with the VAS (r=0.92, N=45) and the CAS (r=0.84, N=45) in this clinical sample. Most children in all age groups including the youngest were able to use the FPS-R in a manner that was consistent with the other measures. There were no significant differences between the means on the FPS-R and either of the analogue Scales. The FPS-R is shown to be appropriate for use in assessment of the intensity of children's acute Pain from age 4 or 5 onward. It has the advantage of being suitable for use with the most widely used metric for scoring (0–10), and conforms closely to a linear interval Scale.
Amy L Drendel - One of the best experts on this subject based on the ideXlab platform.
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comparison of the psychometric properties of 3 Pain Scales used in the pediatric emergency department visual analogue Scale Faces Pain Scale revised and colour analogue Scale
Pain, 2018Co-Authors: Sylvie Le May, Ariane Ballard, Christelle Khadra, Serge Gouin, Amy C Plint, Edith Villeneuve, Benoit Mâsse, Daniel S Tsze, Gina Neto, Amy L DrendelAbstract:Appropriate Pain measurement relies on the use of valid, reliable tools. The aim of this study was to determine and compare the psychometric properties of 3 self-reported Pain Scales commonly used in the pediatric emergency department (ED). The inclusion criteria were children aged 6 to 17 years presenting to the ED with a musculoskeletal injury and self-reported Pain scores ≥30 mm on the mechanical Visual Analogue Scale (VAS). Self-reported Pain intensity was assessed using the mechanical VAS, Faces Pain Scale-Revised (FPS-R), and Colour Analogue Scale (CAS). Convergent validity was assessed by Pearson correlations and the Bland-Altman method; responsiveness to change was assessed using paired sample t tests and standardized mean responses; and reliability was estimated using relative and absolute indices. A total of 456 participants were included, with a mean age of 11.9 years ± 2.7 and a majority were boys (252/456, 55.3%). Correlations between each pair of Scales were 0.78 (VAS/FPS-R), 0.92 (VAS/CAS), and 0.79 (CAS/FPS-R). Limits of agreement (95% confidence interval) were -3.77 to 2.33 (VAS/FPS-R), -1.74 to 1.75 (VAS/CAS), and -2.21 to 3.62 (CAS/FPS-R). Responsiveness to change was demonstrated by significant differences in mean Pain scores among the Scales (P < 0.0001). Intraclass correlation coefficient and coefficient of repeatability estimates suggested acceptable reliability for the 3 Scales at, respectively, 0.79 and ±2.29 (VAS), 0.82 and ±2.07 (CAS), and 0.76 and ±2.82 (FPS-R). The Scales demonstrated good psychometric properties for children with acute Pain in the ED. The VAS and CAS showed a strong convergent validity, whereas FPS-R was not in agreement with the other Scales.
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oral morphine versus ibuprofen administered at home for postoperative orthopedic Pain in children a randomized controlled trial
Canadian Medical Association Journal, 2017Co-Authors: Naveen Poonai, Amy L Drendel, Natasha Datoo, Samina Ali, Megan Cashin, Rongbo Zhu, Natasha Lepore, Michael Greff, Michael J Rieder, Debra BartleyAbstract:BACKGROUND: Oral morphine for postoperative Pain after minor pediatric surgery, while increasingly popular, is not supported by evidence. We evaluated whether oral morphine was superior to ibuprofen for at-home management of children’s postoperative Pain. METHODS: We conducted a randomized superiority trial comparing oral morphine (0.5 mg/kg) with ibuprofen (10 mg/kg) in children 5 to 17 years of age who had undergone minor outpatient orthopedic surgery (June 2013 to September 2016). Participants took up to 8 doses of the intervention drug every 6 hours as needed for Pain at home. The primary outcome was Pain, according to the Faces Pain Scale – Revised, for the first dose. Secondary outcomes included additional analgesic requirements, adverse effects, unplanned health care visits and Pain scores for doses 2 to 8. RESULTS: We analyzed data for 77 participants in each of the morphine and ibuprofen groups. Both interventions decreased Pain scores with no difference in efficacy. The median difference in Pain score before and after the first dose of medication was 1 (interquartile range 0–1) for both morphine and ibuprofen (p = 0.2). For doses 2 to 8, the median differences in Pain score before and after the dose were not significantly different between groups. Significantly more participants taking morphine reported adverse effects (45/65 [69%] v. 26/67 [39%], p INTERPRETATION: Morphine was not superior to ibuprofen, and both drugs decreased Pain with no apparent difference in efficacy. Morphine was associated with significantly more adverse effects, which suggests that ibuprofen is a better first-line option after minor surgery. Trial registration: ClinicalTrials.gov, no. NCT01686802.
Anna Huguet - One of the best experts on this subject based on the ideXlab platform.
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measurement of self reported Pain intensity in children and adolescents
Journal of Psychosomatic Research, 2010Co-Authors: Anna Huguet, Jennifer Stinson, Patrick J McgrathAbstract:Acute and chronic Pain is a common experience in children and youth. A thorough assessment is fundamental to understand this experience and to assess and monitor treatment responses. The intensity of Pain is the parameter most commonly assessed. In this article, we describe the different methods employed to assess pediatric Pain intensity and review well-validated and commonly used self-report measures of Pain. This review is based on the recent systematic reviews conducted for the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials Consensus Group and the Society of Pediatric Psychology. Amongst the several types of pediatric Pain measures, self-report, when available, is regarded as the primary source of information about Pain intensity, to be complemented by observation and knowledge of the context. There is a large number of self-report measures of pediatric Pain intensity; and there is some agreement that professionals in the clinical and research practice should assess Pain intensity using the Pieces of Hurt Tool, the Faces Pain Scale, the Oucher, or Visual Analogue Scales because these measures have shown to have sound psychometric properties and clinical utility. Despite the increased number of age-appropriate self-report measures of pediatric Pain intensity over the last years, we report several research gaps and priorities of future research.
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evidence for the use of a numerical rating Scale to assess the intensity of pediatric Pain
European Journal of Pain, 2009Co-Authors: Jordi Miro, Elena Castarlenas, Anna HuguetAbstract:The aim of this work was to evaluate the psychometric properties of the Numerical Rating Scale-11 (NRS-11) when used to assess pediatric Pain intensity. We performed two studies: 175 schoolchildren, aged 8–12, participated in Study 1 and 63 children undergoing surgery and aged 6–16, participated in Study 2. The NRS-11 showed (a) adequate convergent construct validity when correlated with the Faces Pain Scale – Revised (FPS-R; r1 = 0.78, r2 = 0.93); (b) adequate discriminant validity in relation to measures of Pain-related affect (z1 = 3.55, z2 = 7.62) and disability (z1 = 7.62, z2 = 6.83); and (c) adequate criterion-related validity using measures of Pain-related affect (r1 = .58, r2 = .66), disability (r1 = 0.22, r2 = .39), and quality of life (r2 = −.46). Schoolchildren were asked whether they preferred using the NRS-11 or the FPS-R when reporting the intensity of their Pain. While both sexes and both the younger and older age groups preferred the FPS-R, this preference was more marked among girls and younger children. The NRS-11 has shown an acceptable level of validity for assessing Pain intensity in both samples, however, additional research is needed in order to fully clarify the lower age limit in which the NRS-11 can be used.
Ryan Sambell - One of the best experts on this subject based on the ideXlab platform.
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virtual reality for pediatric needle procedural Pain two randomized clinical trials
The Journal of Pediatrics, 2019Co-Authors: Evelyn Chan, Michael Hovenden, Emma Ramage, Norman Ling, Jeanette H Pham, Ayesha Rahim, Connie Lam, Linly Liu, Samantha Foster, Ryan SambellAbstract:Objective To assess the efficacy and safety of a virtual reality distraction for needle Pain in 2 common hospital settings: the emergency department (ED) and outpatient pathology (ie, outpatient laboratory). The control was standard of care (SOC) practice. Study design In 2 clinical trials, we randomized children aged 4-11 years undergoing venous needle procedures to virtual reality or SOC at 2 tertiary Australian hospitals. In the first study, we enrolled children in the ED requiring intravenous cannulation or venipuncture. In the second, we enrolled children in outpatient pathology requiring venipuncture. In the ED, 64 children were assigned to virtual reality and 59 to SOC. In pathology, 63 children were assigned to virtual reality and 68 to SOC; 2 children withdrew assent in the SOC arm, leaving 66. The primary endpoint was change from baseline Pain between virtual reality and SOC on child-rated Faces Pain Scale-Revised. Results In the ED, there was no change in Pain from baseline with SOC, whereas virtual reality produced a significant reduction in Pain (between-group difference, −1.78; 95% CI, −3.24 to −0.317; P = .018). In pathology, both groups experienced an increase in Pain from baseline, but this was significantly less in the virtual reality group (between-group difference, −1.39; 95% CI, −2.68 to −0.11; P = .034). Across both studies, 10 participants experienced minor adverse events, equally distributed between virtual reality/SOC; none required pharmacotherapy. Conclusions In children aged 4-11 years of age undergoing intravenous cannulation or venipuncture, virtual reality was efficacious in decreasing Pain and was safe. Trial registration Australia and New Zealand Clinical Trial Registry: ACTRN12617000285358p
