Breau Lynn M, Finley G Allen, McGrath Patrick J, Camfield Carol S
Pediatric Pain Research Laboratory, IWK Health Centre, Halifax, Nova Scotia, Canada.
Anesthesiology. 2002 Mar;96(3):528-35. doi: 10.1097/00000542-200203000-00004.
This study evaluated the psychometric properties of the Non-communicating Children's Pain Checklist-Postoperative Version (NCCPC-PV) when used with children with severe intellectual disabilities.
The caregivers of 24 children with severe intellectual disabilities (aged 3-19 yr) took part. Each child was observed by one of their caregivers and one of the researchers for 10 min before and after surgery. They independently completed the NCCPC-PV and made a visual analog scale rating of the child's pain intensity for those times. A nurse also completed a visual analog scale for the same observations.
The NCCPC-PV was internally reliable (Cronbach alpha = 0.91) and showed good interrater reliability. A repeated-measures analysis of variance indicated NCCPC-PV total and subscale scores were significantly higher after surgery and did not differ by observer. Postoperative NCCPC-PV scores correlated with visual analog scale ratings provided by caregivers and researchers, but not with those of nurses. A score of 11 on the NCCPC-PV, by caregivers, provided 0.88 sensitivity and 0.81 specificity for classifying children with moderate to severe pain.
The NCCPC-PV displayed good psychometric properties when used for the postoperative pain of children with severe intellectual disabilities and has the potential to be useful in a clinical setting. The results suggest familiarity with an individual child with intellectual disabilities is not necessary for pain assessment.
本研究评估了非语言沟通儿童疼痛清单术后版(NCCPC - PV)用于重度智力残疾儿童时的心理测量特性。
24名重度智力残疾儿童(年龄3 - 19岁)的照料者参与了研究。在手术前后,每位儿童由其一名照料者和一名研究人员各观察10分钟。他们独立完成NCCPC - PV,并对该时段儿童的疼痛强度进行视觉模拟评分。一名护士也针对相同观察完成了视觉模拟评分。
NCCPC - PV具有内部可靠性(克朗巴哈α系数 = 0.91),且表现出良好的评分者间信度。重复测量方差分析表明,NCCPC - PV总分及各子量表得分在术后显著更高,且不因观察者不同而有差异。术后NCCPC - PV得分与照料者和研究人员提供的视觉模拟评分相关,但与护士提供的评分不相关。照料者使用NCCPC - PV评分为11分时,对中度至重度疼痛儿童分类的敏感度为0.88,特异度为0.81。
NCCPC - PV用于重度智力残疾儿童术后疼痛评估时显示出良好的心理测量特性,并且有可能在临床环境中发挥作用。结果表明,疼痛评估无需熟悉个别智力残疾儿童的情况。