title: Facial expression and pain assessment in the pediatric patient: the primal face of pain.
abstract: OBJECTIVE
  This paper aims to explore the role of facial expression in pediatric pain assessment. A comparison of tools employing facial expression methodology is presented. The concept of the primal face of pain (PFP) is introduced.
  
  
  CONCLUSIONS
  The PFP offers an explanation to the utility and deficiency of facial pain scales and facial expression in pain assessment.
  
  
  CONCLUSIONS
  The complexities of pain measurement should preclude the clinical application of untested instruments. For reported tools, a careful evaluation of the psychometric properties and the clinical context must precede application. The concept of the PFP warns against the application of facial pain scales as proxy measures in their intended population. Reliance on facial expression to assess pain in the school-age child is imprecise.
authors: School of Nursing, University of Rochester, Rochester, NY, USA. martin_schiavenato@urmc.rochester.edu
authors: Martin
authors: M
authors: Schiavenato
mesh_terms: D002648:Child; D002652:Child Behavior; D005149:Facial Expression; D006801:Humans; D009730:Nursing Assessment / Q000379:methods* / Q000592:standards; D015403:Nursing Evaluation Research; D010146:Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement / Q000379:methods* / Q000451:nursing / Q000592:standards; D010371:Pediatric Nursing / Q000379:methods*; D010808:Physical Examination; D002666:Psychology, Child; D011594:Psychometrics; D015203:Reproducibility of Results