title: 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.
authors.affiliation: Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands Burn Centre, Maasstad Hospital, Rotterdam, The Netherlands Burn Centre, Martini Hospital, Groningen, The Netherlands Association of Dutch Burn Centres, Beverwijk, The Netherlands Freelance Epidemiologist, Wijk aan Zee, The Netherlands Department of Reconstructive and Hand Surgery, VU Free University, Amsterdam, The Netherlands.
authors.forename: Alette
authors.initials: A
authors.lastname: de Jong
authors.forename: Martin
authors.initials: M
authors.lastname: Baartmans
authors.forename: Marco
authors.initials: M
authors.lastname: Bremer
authors.forename: Rob
authors.initials: R
authors.lastname: van Komen
authors.forename: Esther
authors.initials: E
authors.lastname: Middelkoop
authors.forename: Wim
authors.initials: W
authors.lastname: Tuinebreijer
authors.forename: Nancy
authors.initials: N
authors.lastname: van Loey
mesh_terms: D002056:Burns / Q000150:complications*; D002652:Child Behavior / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009726:Nurses; D019370:Observation / Q000379:methods; D010146:Pain / Q000175:diagnosis* / Q000209:etiology*; D010147:Pain Measurement / Q000145:classification* / Q000379:methods*; D011594:Psychometrics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D011795:Surveys and Questionnaires