Bieri Daiva, Reeve Robert A, Champion David G, Addicoat Louise, Ziegler John B
Division of Paediatrics, The Prince of Wales Children's Hospital, Sydney Australia School of Behavioural Sciences, Macquarie University, Sydney, N.S.W. Australia.
Pain. 1990 May;41(2):139-150. doi: 10.1016/0304-3959(90)90018-9.
Altogether 553 children (195 first graders, mean age 6.8 years, and 358 third graders, mean age 8.7 years) participated in the development of a self-report measure to assess the intensity of children's pain. The first step was the derivation, from children's drawings of facial expressions of pain, of 5 sets of 7 schematic faces depicting changes in severity of expressed pain from no pain to the most pain possible. With the set of faces that achieved the highest agreement in pain ordering, additional studies were conducted to determine whether the set had the properties of a scale. In one study, children rank-ordered the faces on 2 occasions, separated by 1 week. All 7 faces were correctly ranked by 64% (retest 1 week later, 61%) of grade 1 children and by 86% (retest 89%) of grade 3 children. In a second study, the faces were presented in all possible paired combinations. All 7 faces were correctly placed by 62% (retest 86%) of the younger and by 75% (retest 71%) of the older subjects. A third study asked children to place faces along a scale: a procedure allowing a check on the equality of intervals. The fourth study checked on whether pain was acting as an underlying construct for ordering the faces in memory. We asked whether children perceived the set as a scale by asking if memory for an ordered set of faces was more accurate than for a random set. The final study checked, with 6-year-old children, the test-retest reliability of ratings for recalled experiences of pain. Overall, the faces pain scale incorporates conventions used by children, has achieved strong agreement in the rank ordering of pain, has indications that the intervals are close to equal, and is treated by children as a scale. The test-retest data suggest that it may prove to be a reliable index over time of self-reported pain.
共有553名儿童（195名一年级学生，平均年龄6.8岁，358名三年级学生，平均年龄8.7岁）参与了一项自我报告测量方法的开发，以评估儿童疼痛的强度。第一步是从儿童描绘疼痛面部表情的画作中，得出5组每组7张的示意性面孔，描绘从无疼痛到可能的最剧烈疼痛的疼痛严重程度变化。对于在疼痛排序中达成最高一致性的那组面孔，进行了额外的研究以确定该组是否具有量表的属性。在一项研究中，儿童在两个场合对这些面孔进行排序，间隔为1周。一年级儿童中有64%（1周后重测为61%）、三年级儿童中有86%（重测为89%）能正确对所有7张面孔进行排序。在第二项研究中，这些面孔以所有可能的配对组合呈现。较年幼的受试者中有62%（重测为86%）、较年长的受试者中有75%（重测为71%）能正确放置所有7张面孔。第三项研究要求儿童沿着一个量表放置面孔：这是一种可检验间隔是否相等的程序。第四项研究检验疼痛是否作为一种潜在结构用于在记忆中对面孔进行排序。我们通过询问儿童对于一组有序面孔的记忆是否比对一组随机面孔的记忆更准确来询问他们是否将该组面孔视为一个量表。最后一项研究对6岁儿童回忆的疼痛经历评分的重测信度进行了检验。总体而言，面孔疼痛量表纳入了儿童使用的惯例，在疼痛排序方面达成了高度一致，有迹象表明间隔接近相等，并且儿童将其视为一个量表。重测数据表明，随着时间推移，它可能被证明是自我报告疼痛的可靠指标。
