Ramelet Anne-Sylvie, Rees Nancy, McDonald Susan, Bulsara Max, Abu-Saad Huda Huijer
Women's & Children's Health Service, Nursing Research, Perth, Australia.
Paediatr Anaesth. 2007 Apr;17(4):333-40. doi: 10.1111/j.1460-9592.2006.02115.x.
This study aimed to test the preliminary psychometric properties of the Multidimensional Assessment Pain Scale (MAPS), a clinical instrument developed for assessing postoperative pain in critically ill preverbal children.
The MAPS was developed using pain indicators observed in postoperative critically ill infants. Content validity was established by a panel of experts. The scale was tested for validity and reliability in 43 postoperative children aged 0-31 months admitted to the pediatric intensive care units of two tertiary referral hospitals. Pain was measured concurrently by three independent assessors using the MAPS, the Face, Leg, Activity, Cry, and Consolability scale (FLACC) and the Visual Analog Scale (VAS) to assess concurrent and convergent validity.
Internal consistency was moderate (r = 0.68). Interrater reliability of the MAPS was good (kappa: 0.68-0.84) for all categories and moderate for breathing pattern (kappa = 0.54). Excellent interrater reliability was shown for total MAPS (intraclass correlation 0.91). Agreement measurements between MAPS and FLACC, and MAPS and VAS showed that the risk of measurement error was small.
Although initial psychometric testing of the MAPS shows promising results, the tool requires further psychometric testing, including responsiveness to analgesic effect (currently in progress).
本研究旨在测试多维评估疼痛量表（MAPS）的初步心理测量特性，该量表是一种为评估重症前语言儿童术后疼痛而开发的临床工具。
MAPS是根据术后重症婴儿观察到的疼痛指标开发的。由专家小组确定内容效度。在两家三级转诊医院的儿科重症监护病房收治的43名0至31个月的术后儿童中对该量表进行了效度和信度测试。由三名独立评估者同时使用MAPS、面部、腿部、活动、哭闹和安慰量表（FLACC）以及视觉模拟量表（VAS）测量疼痛，以评估同时效度和聚合效度。
内部一致性中等（r = 0.68）。MAPS在所有类别中的评分者间信度良好（kappa：0.68 - 0.84），呼吸模式方面中等（kappa = 0.54）。MAPS总分显示出极好的评分者间信度（组内相关系数0.91）。MAPS与FLACC以及MAPS与VAS之间的一致性测量表明测量误差风险较小。
尽管MAPS的初步心理测量测试显示出有希望的结果，但该工具需要进一步的心理测量测试，包括对镇痛效果的反应性（目前正在进行）。
