两种用于儿科急诊科的疼痛量表的验证

Validation of 2 pain scales for use in the pediatric emergency department.

作者信息

Bulloch Blake, Tenenbein Milton

机构信息

Children's Hospital, Department of Pediatric Emergency Medicine, Winnipeg, Manitoba, Canada.

出版信息

Pediatrics. 2002 Sep;110(3):e33. doi: 10.1542/peds.110.3.e33.

DOI:10.1542/peds.110.3.e33

PMID:12205283

Abstract

OBJECTIVE

To determine the construct, content, and convergent validity of 2 self-report pain scales for use in the untrained child in the emergency department (ED).

METHODS

A prospective study was conducted of all children who presented to an urban ED between 5 and 16 years of age inclusive after written informed consent was obtained. Children were excluded if they were intoxicated, had altered sensorium, were clinically unstable, did not speak English, or had developmental delays. Children marked their current pain severity on a standardized Color Analog Scale (CAS) and a 7-point Faces Pain Scale (FPS). They were then asked whether their pain was mild, moderate, or severe. Children were then administered an analgesic at the discretion of the attending physician and asked to repeat these measurements. For assessing content validity, the scales were also administered to age- and gender-matched children in the ED for nonpainful conditions. Convergent validity was assessed by determining the Spearman correlation coefficient between the 2 pain scales.

RESULTS

A total of 60 children were enrolled, 30 with pain and 30 without, with a mean age of 9.3 +/- 3.3 years. Boys accounted for 38 of the enrollees (63.3%). The median score before analgesic administration was 6.0 cm (interquartile range [IQR]: 4.0-8.0) on the CAS and 3.0 faces (IQR: 2.0-5.0) on the FPS; after analgesic administration, the median scores decreased to 3.1 cm (IQR: 1.1-4.3) and 2.0 faces (IQR: 1.0-3.0), respectively. As the reported pain intensity increased, so did the scores on the 2 pain scales. The 30 children with no pain had a median score on the CAS of 0.0 (IQR: 0.0-1.0) and on the FPS of 0.0 (IQR: 0.0-1.0), whereas the 13 children with severe pain had a median CAS of 7.0 (IQR: 6.0-8.0) and a median FPS of 5.0 (IQR: 4.0-6.0). The Spearman correlation coefficient between the CAS and the FPS was positive and strong (r = 0.894).

CONCLUSION

The CAS and the FPS exhibit construct, content, and convergent validity in the measurement of acute pain in children in the ED.

摘要

目的

确定两种用于急诊科未受过训练儿童的自我报告疼痛量表的结构效度、内容效度和收敛效度。

方法

在获得书面知情同意后，对所有年龄在5至16岁（含）之间到城市急诊科就诊的儿童进行了一项前瞻性研究。如果儿童处于醉酒状态、意识改变、临床不稳定、不会说英语或有发育迟缓，则将其排除。儿童在标准化的颜色模拟量表（CAS）和7点面部疼痛量表（FPS）上标记他们当前的疼痛严重程度。然后询问他们的疼痛是轻度、中度还是重度。然后由主治医生酌情给儿童服用镇痛药，并要求他们重复这些测量。为了评估内容效度，还对急诊科中年龄和性别匹配的无疼痛情况的儿童使用了这些量表。通过确定两种疼痛量表之间的斯皮尔曼相关系数来评估收敛效度。

结果

共招募了60名儿童，其中30名有疼痛，30名无疼痛，平均年龄为9.3±3.3岁。男孩占38名受试者（63.3%）。服用镇痛药前，CAS的中位数为6.0厘米（四分位间距[IQR]：4.0 - 8.0），FPS为3.0个面部表情（IQR：2.0 - 5.0）；服用镇痛药后，中位数分别降至3.1厘米（IQR：1.1 - 4.3）和2.0个面部表情（IQR：1.0 - 3.0）。随着报告的疼痛强度增加，两种疼痛量表的得分也增加。30名无疼痛儿童的CAS中位数为0.0（IQR：0.0 - 1.0），FPS为0.0（IQR：0.0 - 1.0），而13名重度疼痛儿童的CAS中位数为7.0（IQR：6.0 - 8.0），FPS中位数为5.0（IQR：4.0 - 6.0）。CAS和FPS之间的斯皮尔曼相关系数为正且强（r = 0.894）。