title: Construct validity and reliability of a real-time multidimensional smartphone app to assess pain in children and adolescents with cancer.
abstract: We evaluated the construct validity (including responsiveness), reliability, and feasibility of the Pain Squad multidimensional smartphone-based pain assessment application (app) in children and adolescents with cancer, using 2 descriptive studies with repeated measures. Participants (8-18 years) undergoing cancer treatment were drawn from 4 pediatric cancer centers. In study 1, 92 participants self-reported their level of pain twice daily for 2 weeks using the Pain Squad app to assess app construct validity and reliability. In study 2, 14 participants recorded their level of pain twice a day for 1 week before and 2 weeks after cancer-related surgery to determine app responsiveness. Participants in both studies completed multiple measures to determine the construct validity and feasibility of the Pain Squad app. Correlations between average weekly pain ratings on the Pain Squad app and recalled least, average, and worst weekly pain were moderate to high (0.43-0.68). Correlations with health-related quality of life and pain coping (measured with PedsQL Inventory 4.0, PedsQL Cancer Module, and Pain Coping Questionnaire) were -0.46 to 0.29. The app showed excellent internal consistency (α = 0.96). Pain ratings changed because of surgery with large effect sizes between baseline and the first week postsurgery (>0.85) and small effect sizes between baseline and the second week postsurgery (0.13-0.32). These findings provide evidence of the construct validity, reliability, and feasibility of the Pain Squad app in children and adolescents with cancer. Use of real-time data capture approaches should be considered in future studies of childhood cancer pain. A video accompanying this abstract is available online as Supplemental Digital Content at http://links.lww.com/PAIN/A169.
authors.affiliation: Departments of Child Health Evaluative Sciences and Anaesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada Lawrence S. Bloomberg Faculty of Nursing Faculty of Medicine, University of Toronto, Toronto, ON, Canada Department of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada Departments of Pharmacy General Surgery, and Orthopaedic Surgery, Hospital for Sick Children, Toronto, ON, Canada Faculty of Medicine, Duke University, Durham, NC, USA Department of Haematology/Oncology, BC Children's Hospital, Vancouver, BC, Canada Department of Haematology/Oncology, McMaster Children's Hospital, Hamilton, ON, Canada Department of Haematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Stinson
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Jibb
authors.forename: Cynthia
authors.initials: C
authors.lastname: Nguyen
authors.forename: Paul C
authors.initials: PC
authors.lastname: Nathan
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Maloney
authors.forename: L Lee
authors.initials: LL
authors.lastname: Dupuis
authors.forename: J Ted
authors.initials: JT
authors.lastname: Gerstle
authors.forename: Sevan
authors.initials: S
authors.lastname: Hopyan
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Alman
authors.forename: Caron
authors.initials: C
authors.lastname: Strahlendorf
authors.forename: Carol
authors.initials: C
authors.lastname: Portwine
authors.forename: Donna L
authors.initials: DL
authors.lastname: Johnston
mesh_terms: D000293:Adolescent; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D063731:Mobile Applications; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D010147:Pain Measurement / Q000295:instrumentation*; D011446:Prospective Studies; D015203:Reproducibility of Results; D057566:Self Report; D000068997:Smartphone