Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, USA.
Acad Emerg Med. 2010 Jan;17(1):50-4. doi: 10.1111/j.1553-2712.2009.00620.x. Epub 2009 Dec 9.
The Wong-Baker FACES Pain Rating Scale (WBS), used in children to rate pain severity, has been validated outside the emergency department (ED), mostly for chronic pain. The authors validated the WBS in children presenting to the ED with pain by identifying a corresponding mean value of the visual analog scale (VAS) for each face of the WBS and determined the relationship between the WBS and VAS. The hypothesis was that the pain severity ratings on the WBS would be highly correlated (Spearman's rho > 0.80) with those on a VAS.
This was a prospective, observational study of children ages 8-17 years with pain presenting to a suburban, academic pediatric ED. Children rated their pain severity on a six-item ordinal faces scale (WBS) from none to worst and a 100-mm VAS from least to most. Analysis of variance (ANOVA) was used to compare mean VAS scores across the six ordinal categories. Spearman's correlation (rho) was used to measure agreement between the continuous and ordinal scales.
A total of 120 patients were assessed: the median age was 13 years (interquartile range [IQR] = 10-15 years), 50% were female, 78% were white, and six patients (5%) used a language other than English at home. The most commonly specified locations of pain were extremity (37%), abdomen (19%), and back/neck (11%). The mean VAS increased uniformly across WBS categories in increments of about 17 mm. ANOVA demonstrated significant differences in mean VAS across face groups. Post hoc testing demonstrated that each mean VAS was significantly different from every other mean VAS. Agreement between the WBS and VAS was excellent (rho = 0.90; 95% confidence interval [CI] = 0.86 to 0.93). There was no association between age, sex, or pain location with either pain score.
The VAS was found to have an excellent correlation in older children with acute pain in the ED and had a uniformly increasing relationship with WBS. This finding has implications for research on pain management using the WBS as an assessment tool.
用于评估儿童疼痛严重程度的 Wong-Baker FACES 疼痛评分量表（WBS）已在急诊科以外的环境中得到验证，主要用于评估慢性疼痛。作者通过确定 WBS 每个面部表情对应的视觉模拟量表（VAS）的均值，验证了该量表在因疼痛而就诊于急诊科的儿童中的有效性，并确定了 WBS 与 VAS 之间的关系。作者的假设是，WBS 的疼痛严重程度评分与 VAS 的评分高度相关（Spearman's rho > 0.80）。
这是一项针对 8-17 岁因疼痛而就诊于郊区学术性儿科急诊科的儿童的前瞻性观察性研究。儿童使用 6 项 ordinal faces scale（WBS）对疼痛程度进行评估，从无到最严重，使用 100-mm VAS 从最轻微到最严重。方差分析（ANOVA）用于比较 6 个 ordinal 类别之间的平均 VAS 评分。Spearman 相关系数（rho）用于衡量连续量表和 ordinal 量表之间的一致性。
共评估了 120 例患者：中位年龄为 13 岁（四分位距 [IQR] = 10-15 岁），50%为女性，78%为白人，6 例患者（5%）在家中使用英语以外的语言。最常见的疼痛部位是四肢（37%）、腹部（19%）和背部/颈部（11%）。WBS 类别中 VAS 的均值均匀增加，增量约为 17mm。ANOVA 显示，面部组之间的 VAS 均值存在显著差异。事后检验显示，每个 VAS 的均值与其他所有 VAS 的均值均有显著差异。WBS 与 VAS 之间的一致性非常好（rho = 0.90；95%置信区间 [CI] = 0.86 至 0.93）。年龄、性别或疼痛部位与任一疼痛评分均无关联。
在急诊科有急性疼痛的较大儿童中，VAS 被发现具有极好的相关性，且与 WBS 呈均匀递增关系。这一发现对使用 WBS 作为评估工具进行疼痛管理研究具有重要意义。
