Department of Nursing, The University of Melbourne, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia.
Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
J Pain. 2018 Jun;19(6):660-669. doi: 10.1016/j.jpain.2018.01.012. Epub 2018 Feb 14.
The Modified Behavioral Pain Scale (MBPS) was designed to assess procedural pain in infants and is considered valid for assessing immunization pain. The aim of this study was to assess the practical and psychometric properties of the MBPS when applied to other commonly performed procedures. Twenty-six clinicians independently applied the MBPS scale to segments of video collected from 100 infants and children aged 6 to 42 months undergoing 1 of 4 procedures in the emergency department. Positive correlation between MBPS and Visual Analogue Scale observer applied (VASobs) pain (r = .74) was shown and inter- and intrarater reliability coefficients were high (.87 and .89, respectively). Construct validity was shown by scale responsiveness to painful stimuli (4.6 times increase in scores across phases) and the capacity of the scale to distinguish between painful versus nonpainful procedures (P < .001). However, mean baseline scores for procedures were not 0 (likely a function of item descriptors for a "0" score) and the mean difference increased across phases for children with baseline scores >3, which was much lower than for children with scores <3 (P = .0001). Finally, 28% of scores changed after the second viewing of a video segment. The MBPS appears reliable and sensitive to procedural pain when applied by clinicians. Results question the capacity of the scale to differentiate between pain- and nonpain-related distress, the feasibility of this scale, and the appropriateness of item descriptors for medical procedures.
This article presents the psychometric and practical properties of the MBPS applied to assess procedural pain. Identification of a suitable scale for this purpose will support improved pain management in infants and young children who undergo painful procedures.
改良行为疼痛量表（MBPS）旨在评估婴儿的手术疼痛，被认为可用于评估疫苗接种疼痛。本研究旨在评估 MBPS 在应用于其他常见手术时的实用性和心理计量学特性。26 名临床医生独立地将 MBPS 量表应用于从 100 名年龄在 6 至 42 个月的婴儿和儿童中收集的视频片段，这些儿童在急诊科接受 4 种程序中的 1 种。MBPS 和观察者应用的视觉模拟量表疼痛（VASobs）之间显示出正相关（r =.74），并且内部和内部评估者可靠性系数很高（分别为.87 和.89）。通过对疼痛刺激的量表反应性（分数在各阶段增加 4.6 倍）和区分疼痛与非疼痛程序的能力（P <.001）显示出结构有效性。然而，对于程序的平均基线分数不为 0（可能是“0”分数的项目描述的函数），并且对于基线分数> 3 的儿童，平均差异在各阶段增加，而对于基线分数<3 的儿童则要低得多（P =.0001）。最后，28％的分数在观看视频片段的第二次后发生了变化。MBPS 在临床医生应用时似乎可靠且对手术疼痛敏感。结果对量表区分疼痛和非疼痛相关痛苦的能力，该量表的可行性以及针对医疗程序的项目描述符的适当性提出了质疑。
本文介绍了 MBPS 应用于评估手术疼痛的心理计量学和实用性特征。为达到此目的而识别出合适的量表将支持对接受痛苦手术的婴儿和幼儿进行更好的疼痛管理。
