Ruskin Danielle, Lalloo Chitra, Amaria Khushnuma, Stinson Jennifer N, Kewley Erika, Campbell Fiona, Brown Stephen C, Jeavons Michael, McGrath Patricia A
Pain Res Manag. 2014 May-Jun;19(3):141-8. doi: 10.1155/2014/856513. Epub 2014 Apr 7.
In clinical practice, children are often asked to rate their pain intensity on a simple 0 to 10 numerical rating scale (NRS). Although the NRS is a well-established measure for adults, no study has yet evaluated its validity for children with chronic pain.
To examine the convergent and discriminant validity of the NRS as it is used within regular clinical practice to document pain intensity for children with chronic pain. Interchangeability between the NRS and an analogue pain measure was also assessed.
A cohort of 143 children (mean [± SD] age 14.1±2.4 years; 72% female) rated their pain intensity (current, usual, lowest and strongest levels) on a verbally administered 0 to 10 NRS during their first appointment at a specialized pain clinic. In a separate session that occurred either immediately before or after their appointment, children also rated their pain using the validated 0 to 10 coloured analogue scale (CAS).
NRS ratings met a priori criteria for convergent validity (r>0.3 to 0.5), correlating with CAS ratings at all four pain levels (r=0.58 to 0.68; all P<0.001). NRS for usual pain intensity differed significantly from an affective pain rating, as hypothesized (Z=2.84; P=0.005), demonstrating discriminant validity. The absolute differences between NRS and CAS pain scores were small (range 0.98±1.4 to 1.75±1.9); however, the two scales were not interchangeable.
The present study provides preliminary evidence that the NRS is a valid measure for assessing pain intensity in children with chronic pain.
在临床实践中，常要求儿童在简单的0至10数字评分量表（NRS）上对其疼痛强度进行评分。尽管NRS是一种针对成人的成熟测量方法，但尚无研究评估其对慢性疼痛儿童的有效性。
检验在常规临床实践中用于记录慢性疼痛儿童疼痛强度的NRS的收敛效度和区分效度。还评估了NRS与视觉模拟疼痛量表之间的互换性。
143名儿童（平均[±标准差]年龄14.1±2.4岁；72%为女性）在专门疼痛诊所首次就诊时，通过口头方式在0至10的NRS上对其疼痛强度（当前、通常、最低和最强水平）进行评分。在预约就诊之前或之后的单独时段，儿童还使用经过验证的0至10彩色视觉模拟量表（CAS）对其疼痛进行评分。
NRS评分符合收敛效度的先验标准（r>0.3至0.5），在所有四个疼痛水平上与CAS评分相关（r=0.58至0.68；所有P<0.001）。如假设的那样，通常疼痛强度的NRS与情感性疼痛评分有显著差异（Z=2.84；P=0.005），显示出区分效度。NRS和CAS疼痛评分之间的绝对差异较小（范围为0.98±1.4至1.75±1.9）；然而，这两个量表不可互换。
本研究提供了初步证据，表明NRS是评估慢性疼痛儿童疼痛强度的有效方法。
