title: Validity of Simplified Versus Standard Self-Report Measures of Pain Intensity in Preschool-Aged Children Undergoing Venipuncture.
abstract: There are inadequate age-specific data to support the use of current self-report pain scales in 3- and 4-year-old children. Most preschool-aged children also lack the necessary cognitive development to use standard scales. We aimed to evaluate the validity and feasibility of 2 novel simplified scales (Simplified Faces Pain Scale, S-FPS; Simplified Concrete Ordinal Scale, S-COS) for preschool-aged children. These simplified scales used a 2-step self-report method: children were first asked whether they have pain (yes/no); only if yes, then pain intensity was self-reported using a 3-point scale with visual aids signifying mild/moderate/severe. We recruited 180 3- to 6-year-old children undergoing routine blood collection. Each child was randomly assigned 2 of 3 scales-S-FPS, S-COS, Faces Pain Scale-Revised (FPS-R)-to self-report pain before venipuncture, immediately after, and 5 minutes later, using both scales at each time-point. Pain was also assessed using observation (Face Legs Activity Cry Consolability) at each time point. The ability to discriminate pain from no pain was improved with S-FPS and S-COS, compared with the FPS-R, among 4-year-olds, but not 3-year-olds. Correlation with Face Legs Activity Cry Consolability was moderate to strong and cooperation rates were similar for all self-report scales. The simplified scales can improve and simplify pain assessment for 4-year-olds. Quantitative pain rating remains challenging for 3-year-olds.
  
  
  
  This study evaluated 2 novel simplified pain assessment tools for preschool-aged children undergoing blood sampling. These scales demonstrated good validity and feasibility compared with the FPS-R, suggesting these simplified pain scales may have a role in clinical practice for children as young as 4 years.
authors.affiliation: Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: anthony.emmott@alumni.ubc.ca.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Emmott
authors.affiliation: Department of Pediatric Anesthesia, BC Children's Hospital, and Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Nicholas
authors.initials: N
authors.lastname: West
authors.affiliation: Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Guohai
authors.initials: G
authors.lastname: Zhou
authors.affiliation: Department of Pediatric Anesthesia, BC Children's Hospital, and Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Dustin
authors.initials: D
authors.lastname: Dunsmuir
authors.affiliation: Department of Pediatric Anesthesia, BC Children's Hospital, and Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Carolyne J
authors.initials: CJ
authors.lastname: Montgomery
authors.affiliation: Department of Pediatric Anesthesia, BC Children's Hospital, and Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Gillian R
authors.initials: GR
authors.lastname: Lauder
authors.affiliation: Department of Clinical Health Psychology and Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Carl L
authors.initials: CL
authors.lastname: von Baeyer
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D010147:Pain Measurement / Q000379:methods*; D018962:Phlebotomy / Q000009:adverse effects*; D015203:Reproducibility of Results; D057566:Self Report; D013997:Time Factors
keywords: Child; pain measurement/methods; pain measurement/standards; self report/standards