Departments of Child Health Evaluative Sciences and Anaesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada Lawrence S. Bloomberg Faculty of Nursing Faculty of Medicine, University of Toronto, Toronto, ON, Canada Department of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada Departments of Pharmacy General Surgery, and Orthopaedic Surgery, Hospital for Sick Children, Toronto, ON, Canada Faculty of Medicine, Duke University, Durham, NC, USA Department of Haematology/Oncology, BC Children's Hospital, Vancouver, BC, Canada Department of Haematology/Oncology, McMaster Children's Hospital, Hamilton, ON, Canada Department of Haematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
Pain. 2015 Dec;156(12):2607-2615. doi: 10.1097/j.pain.0000000000000385.
We evaluated the construct validity (including responsiveness), reliability, and feasibility of the Pain Squad multidimensional smartphone-based pain assessment application (app) in children and adolescents with cancer, using 2 descriptive studies with repeated measures. Participants (8-18 years) undergoing cancer treatment were drawn from 4 pediatric cancer centers. In study 1, 92 participants self-reported their level of pain twice daily for 2 weeks using the Pain Squad app to assess app construct validity and reliability. In study 2, 14 participants recorded their level of pain twice a day for 1 week before and 2 weeks after cancer-related surgery to determine app responsiveness. Participants in both studies completed multiple measures to determine the construct validity and feasibility of the Pain Squad app. Correlations between average weekly pain ratings on the Pain Squad app and recalled least, average, and worst weekly pain were moderate to high (0.43-0.68). Correlations with health-related quality of life and pain coping (measured with PedsQL Inventory 4.0, PedsQL Cancer Module, and Pain Coping Questionnaire) were -0.46 to 0.29. The app showed excellent internal consistency (α = 0.96). Pain ratings changed because of surgery with large effect sizes between baseline and the first week postsurgery (>0.85) and small effect sizes between baseline and the second week postsurgery (0.13-0.32). These findings provide evidence of the construct validity, reliability, and feasibility of the Pain Squad app in children and adolescents with cancer. Use of real-time data capture approaches should be considered in future studies of childhood cancer pain. A video accompanying this abstract is available online as Supplemental Digital Content at http://links.lww.com/PAIN/A169.
我们通过两项具有重复测量的描述性研究评估了 Pain Squad 多维智能手机疼痛评估应用（app）在癌症儿童和青少年中的结构效度（包括反应度）、信度和可行性。参与者（8-18 岁）来自 4 家儿科癌症中心，正在接受癌症治疗。在研究 1 中，92 名参与者使用 Pain Squad app 每天自我报告两次疼痛水平，持续 2 周，以评估 app 的结构效度和信度。在研究 2 中，14 名参与者在癌症相关手术前和手术后的一周内每天记录两次疼痛水平，以确定 app 的反应度。两项研究中的参与者都完成了多项测量，以确定 Pain Squad app 的结构效度和可行性。Pain Squad app 上每周平均疼痛评分与回忆的最低、平均和最差每周疼痛评分之间的相关性为中度至高度（0.43-0.68）。与健康相关的生活质量和疼痛应对（使用 PedsQL Inventory 4.0、PedsQL Cancer Module 和 Pain Coping Questionnaire 进行测量）的相关性为-0.46 至 0.29。app 显示出极好的内部一致性（α=0.96）。由于手术，疼痛评分发生了变化，手术前后第 1 周的效应量较大（>0.85），而手术前后第 2 周的效应量较小（0.13-0.32）。这些发现为 Pain Squad app 在癌症儿童和青少年中的结构效度、信度和可行性提供了证据。在未来的儿童癌症疼痛研究中，应考虑使用实时数据采集方法。本文的配套视频可在网上作为补充数字内容查看，网址为 http://links.lww.com/PAIN/A169。
