Development and Validation of a Pictorial Nausea Rating Scale for Children

Abstract

OBJECTIVE: The lack of a widely used, validated measure limits pediatric nausea management. The goal of this study was to create and validate a pictorial scale with regular incremental levels between scores depicting increasing nausea intensity. METHODS: A pictorial nausea scale of 0 to 10 with 6 faces (the Baxter Retching Faces [BARF] scale) was developed in 3 stages. The BARF scale was validated in emergency department patients with vomiting and in healthy patients undergoing day surgery procedures. Patients were presented with visual analog scales for nausea and pain, the pictorial Faces Pain Scale–Revised, and the BARF scale. Patients receiving opioid analgesics or antiemetic agents had their pain and nausea assessed before and 30 minutes after therapy. Spearman's ρ correlation coefficients were calculated. A Wilcoxon matched-pair rank test compared pain and nausea scores before and after antiemetic therapy. RESULTS: Thirty oncology patients and 15 nurses participated in the development of the scale, and 127 patients (52, emergency department; 75, day surgery) ages 7 to 18 years participated in the validation. The Spearman ρ correlation coefficient of the first paired BARF and visual analog scale for nausea scores was 0.93. Visual analog scales for nausea and BARF scores (P = .20) were significantly higher in patients requiring antiemetic agents and decreased significantly after treatment, while posttreatment pain scores (P = .47) for patients receiving only antiemetic agents did not. CONCLUSIONS: We describe the development of a pictorial scale with beginning evidence of construct validity for a self-report assessment of the severity of pediatric nausea. The scale had convergent and discriminant validity, along with an ability to detect change after treatment.

Acupuncture versus Usual Care for Postoperative Nausea and Vomiting in Children after Tonsillectomy/Adenoidectomy: A Pragmatic, Multicentre, Double-Blinded, Randomised Trial

“…15 Likewise, the BARF had a strong correlation (Spearman r=0.93) with the Visual Analogue Scale for nausea. 16 …”

Development of an Online Library of Patient-Reported Outcome Measures in Gastroenterology: The GI-PRO Database

“…The PROs cover a range of conditions, including achalasia (23), celiac sprue (24,25), dyspepsia (26–43), eosinophilic esophagitis (44), fecal incontinence (45–60), functional GI disorders (25,41,49,53,60–86), gastroesophageal reflux disease (30,38–40,43,87–110), GI malignancies (48,77,111–115), postgastrectomy (113,116), ileal conduit diversion (117), ileostomy (118), inflammatory bowel disease (119–127), pregnancy-related GI symptoms (128–130), systemic sclerosis (131–133), and radiation enteritis (57), among others. In all, 15 PROs apply to the pediatric population (44,45,60,77,80,97,100,102,115,123,124,134–137), and 6 apply specifically to women (56,128–130,138,139). …”

“…Our search revealed 11 PROs with items pertaining to nausea and vomiting (44,66,110,115,128–130,136,137, 140,148,149). These items capture a range of increasingly severe foregut symptoms that begins with feeling sick to the stomach and ends with vomiting up stomach contents.…”

Can a magic wand plausibly be used in serious psychological research? The complications of researching the ideal age at which to be a parent through the eyes of the child

“…Let us take the pictorial scales used to measure pain in children as an example of a widespread practical use of projective interviewing, e.g. Wong's scale or Baxter Retching Faces (Baxter et al, 2011). Thanks to the evoked projection, these are essential tools for accessing children's perceptions of pain and cannot be replaced by any other objective technique.…”