Department of Pediatrics, Division of Pediatric Emergency Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Ann Emerg Med. 2018 Jun;71(6):691-702.e3. doi: 10.1016/j.annemergmed.2017.09.009. Epub 2017 Nov 6.
The Verbal Numerical Rating Scale is the most commonly used self-report measure of pain intensity. It is unclear how the validity and reliability of the scale scores vary across children's ages. We aimed to determine the validity and reliability of the scale for children presenting to the emergency department across a comprehensive spectrum of age.
This was a cross-sectional study of children aged 4 to 17 years. Children self-reported their pain intensity, using the Verbal Numerical Rating Scale and Faces Pain Scale-Revised at 2 serial assessments. We evaluated convergent validity (strong validity defined as correlation coefficient ≥0.60), agreement (difference between concurrent Verbal Numerical Rating Scale and Faces Pain Scale-Revised scores), known-groups validity (difference in score between children with painful versus nonpainful conditions), responsivity (decrease in score after analgesic administration), and reliability (test-retest at 2 serial assessments) in the total sample and subgroups based on age.
We enrolled 760 children; 27 did not understand the Verbal Numerical Rating Scale and were removed. Of the remainder, Pearson correlations were strong to very strong (0.62 to 0.96) in all years of age except 4 and 5 years, and agreement was strong for children aged 8 and older. Known-groups validity and responsivity were strong in all years of age. Reliability was strong in all age subgroups, including each year of age from 4 to 7 years.
Convergent validity, known-groups validity, responsivity, and reliability of the Verbal Numerical Rating Scale were strong for children aged 6 to 17 years. Convergent validity was not strong for children aged 4 and 5 years. Our findings support the use of the Verbal Numerical Rating Scale for most children aged 6 years and older, but not for those aged 4 and 5 years.
言语数字评分量表是最常用于自我报告疼痛强度的测量工具。目前尚不清楚该量表评分在儿童各年龄段的有效性和可靠性有何差异。我们旨在确定该量表在综合年龄段就诊于急诊科的儿童中的有效性和可靠性。
这是一项 4 至 17 岁儿童的横断面研究。儿童在 2 次连续评估中使用言语数字评分量表和修订面部疼痛评分量表自我报告疼痛强度。我们评估了效标关联效度（强关联定义为相关系数≥0.60）、一致性（同期言语数字评分量表和修订面部疼痛评分量表之间的差异）、已知组间差异（有疼痛和无疼痛儿童之间的评分差异）、反应性（镇痛后评分下降）和总样本以及基于年龄的亚组中的可靠性（2 次连续评估的测试-再测试）。
我们共纳入 760 名儿童；27 名儿童不理解言语数字评分量表，被剔除。除 4 岁和 5 岁外，其余各年龄段的 Pearson 相关系数均较强至很强（0.62 至 0.96），且 8 岁及以上儿童的一致性较强。所有年龄段的已知组间差异和反应性均较强。所有年龄亚组的可靠性均较强，包括 4 岁至 7 岁的各年龄段。
6 至 17 岁儿童的言语数字评分量表的效标关联效度、已知组间差异、反应性和可靠性较强。4 岁和 5 岁儿童的效标关联效度不强。我们的研究结果支持大多数 6 岁及以上儿童使用言语数字评分量表，但不支持 4 岁和 5 岁儿童使用。
