Reliability, validity and clinical utility of three types of pain behavioural observation scales for young children with burns aged 0–5 years

Abstract

Pain measurement is a prerequisite for individualized pain management and research into pain interventions. There is a need for reliable and valid pain measures for young children with burns. The aim of this study was to investigate whether the pain observation scale for young children (POCIS), the COMFORT behaviour scale (COMFORT-B) and the nurse observational visual analogue scale (VAS obs) are reliable, valid and clinically useful instruments to measure pain in children with burns aged 0-5years. Participating trained nurses (N=102) rated pain of 154 children during hospitalization. Two trained nurses simultaneously assessed pain at fixed intervals by using the previous mentioned measures. Cronbach's alpha for POCIS was .87 for background and .89 for procedural pain. Intraclass Correlation Coefficients (ICCs) were .75 for background and .81 for procedural pain. COMFORT-B observations yielded Cronbach's alpha of .77 for background and .86 for procedural pain and ICCs of .83 for background and .82 for procedural pain. The VAS obs resulted in ICCs of .55 for background and .60 for procedural pain. Correlation coefficient between POCIS and COMFORT-B was .79 (p<.01), Standardized response mean was 1.04 for both POCIS and COMFORT-B. Background pain measured with POCIS and COMFORT-B was lower than procedural pain (p<.001). Nurses found POCIS easier and quicker to use, but COMFORT-B was found to indicate pain more accurately. Both POCIS and COMFORT-B are reliable, valid and practical scales for pain measurement in young children with burns and can be used in practice and research. The VAS obs was found to be unreliable.

Pruritus in Pediatric Burn Survivors

“…However, numerical scales have demonstrated problems with reliability in small children. 35,36 The recently developed 5D itch scale is a more detailed pruritus questionnaire that examines five dimensions of itch (degree, duration, direction, disability, and distribution) with established reliability and validity in the adult population; it has not been validated in children. 37,38 The Itch Man Scale is a detailed, child-specific pruritus assessment for burn survivors that was recently developed and validated.…”

Pain assessment scales in newborns: integrative review

“…As for the age range by scale, it was observed that the CHIPPS and COMFORT-B scales assess pain in children aged zero to five years; the FLACC, RIPS, COMFORT and NAPI scales, from zero to three years; VAS, from zero to 4 years; MAPS, from zero to 31 months, and the Hartwig scale, from zero to one year,17 , 39 , 44 , 50 which are common to newborns and children. …”

Procedural Pain Scale Evaluation (PROPoSE) study: protocol for an evaluation of the psychometric properties of behavioural pain scales for the assessment of procedural pain in infants and children aged 6–42 months

“…Feasibility and clinical utility will be tested using a series of self-report statements, first used by de Jong et al 32 and also by Taddio and colleagues in their study addressing the psychometric properties of MBPS. 36 The results will be summarised descriptively and compared between scales.…”