Medical College of Georgia, Pediatric Emergency Medicine Associates, Atlanta, Georgia, USA.
Pediatrics. 2011 Jun;127(6):e1542-9. doi: 10.1542/peds.2010-1410. Epub 2011 May 29.
The lack of a widely used, validated measure limits pediatric nausea management. The goal of this study was to create and validate a pictorial scale with regular incremental levels between scores depicting increasing nausea intensity.
A pictorial nausea scale of 0 to 10 with 6 faces (the Baxter Retching Faces [BARF] scale) was developed in 3 stages. The BARF scale was validated in emergency department patients with vomiting and in healthy patients undergoing day surgery procedures. Patients were presented with visual analog scales for nausea and pain, the pictorial Faces Pain Scale-Revised, and the BARF scale. Patients receiving opioid analgesics or antiemetic agents had their pain and nausea assessed before and 30 minutes after therapy. Spearman's ρ correlation coefficients were calculated. A Wilcoxon matched-pair rank test compared pain and nausea scores before and after antiemetic therapy.
Thirty oncology patients and 15 nurses participated in the development of the scale, and 127 patients (52, emergency department; 75, day surgery) ages 7 to 18 years participated in the validation. The Spearman ρ correlation coefficient of the first paired BARF and visual analog scale for nausea scores was 0.93. Visual analog scales for nausea and BARF scores were significantly higher in patients requiring antiemetic agents (P = .0001) and decreased significantly after treatment (P = .0002), while posttreatment VAS (P = .20) and FPSR scores (P =.47) for patients receiving only antiemetic agents did not [corrected].
We describe the development of a pictorial scale with beginning evidence of construct validity for a self-report assessment of the severity of pediatric nausea. The scale had convergent and discriminant validity, along with an ability to detect change after treatment.
缺乏广泛使用且经过验证的测量方法限制了儿科恶心管理。本研究的目的是创建和验证一种具有规则递增评分级别的图像量表，以描绘恶心强度的增加。
通过三个阶段开发了 0 到 10 的图像恶心量表，共 6 张脸（Baxter 呕吐脸[BARF]量表）。在急诊科呕吐患者和接受日间手术的健康患者中验证了 BARF 量表。向患者展示视觉模拟量表用于评估恶心和疼痛、修订后的面部疼痛量表-修订版和 BARF 量表。接受阿片类镇痛药或止吐药的患者在治疗前后 30 分钟评估疼痛和恶心。计算 Spearman ρ 相关系数。Wilcoxon 配对秩检验比较止吐治疗前后的疼痛和恶心评分。
30 名肿瘤患者和 15 名护士参与了量表的制定，127 名年龄在 7 至 18 岁的患者（52 名急诊科，75 名日间手术）参与了验证。BARF 量表和视觉模拟量表恶心评分的第一对 Spearman ρ 相关系数为 0.93。需要止吐药的患者的视觉模拟量表恶心评分和 BARF 评分明显更高（P =.0001），治疗后显著降低（P =.0002），而仅接受止吐药的患者治疗后 VAS（P =.20）和 FPSR 评分（P =.47）无显著差异。
我们描述了一种图像量表的开发，该量表具有用于自我报告评估儿科恶心严重程度的初步结构有效性证据。该量表具有收敛和判别有效性，并且能够在治疗后检测到变化。
