Clinimetric Evaluation of the Pain Observation Scale for Young Children in Children Aged Between 1 and 4 Years after Ear, Nose, and Throat Surgery

Abstract

This study assessed the reliability, validity, and responsiveness of a new pain measure for children aged 1 to 4 years that was developed from the Children's Hospital of Ontario Pain Scale and its Neonatal Infant Pain Scale. Pain in 311 children, aged 1 to 4 years, was measured by two observers at fixed intervals after adenotonsillectomy (n = 114), adenotomy (n = 109), or insertion of ventilation tubes (grommets) (n = 88) until discharge using a dichotomous pain scale of 9 behavioral and physiological categories. The scale proved to be strongly homogeneous. The interobserver agreement was substantial for 7 items. On these final 7 items, the ability to distinguish between patients with differing degrees of pain and the sensitivity to detect changes over time within each patient were substantial. The resulting Pain Observation Scale for Young Children is reliable and easy to use for assessment of short- and longer-lasting pain after ear, nose, and throat surgery and may be used for assessing pain with other conditions.

Pain in Children: Assessment and Nonpharmacological Management

“…It is intended to measure pain in children aged 1 to 4 years, and is used to assess pain of short or long duration [38]. The scale was primarily produced at the University of Amsterdam in the Netherlands.…”

“…The scale was primarily produced at the University of Amsterdam in the Netherlands. The scale measures 7 parameters: facial expression, cry, breathing, torso, arms and fingers, legs and toes, and states of arousal [38]. The OPS has a simple scoring system which makes it easy to use by all healthcare professionals to obtain valid and reliable results [39].…”

“…The OPS has a simple scoring system which makes it easy to use by all healthcare professionals to obtain valid and reliable results [39]. The indicators are rated from 0-1 with a maximum score of 7, where the higher score indicates greater discomfort [38]. …”

Pain assessment for the PACU nurse: Science or art?

“…7-15 Several pain tools that include patterns of distress behaviors characteristically associated with pain have been developed and tested in adults, children, or in individuals with cognitive impairment. 7,8,10,[13][14][15][16][17][18][19][20][21][22] Although such pain tools differ in content and style, all incorporate facial expression and vocalization categories, and most assess posture, movement, or positioning. Some tools assess social interaction or consolability, 10,21-24 and others incorporate physiological changes 17 or assessment of breathing pattern.…”

“…Some tools assess social interaction or consolability, 10,21-24 and others incorporate physiological changes 17 or assessment of breathing pattern. 13 Table 1 presents several commonly cited observational pain scales that may be useful in assessing pain in the PACU setting.…”