Department of Physical Medicine and Rehabilitation, Sapienza University, Rome, Italy.
Department of Physical Medicine and Rehabilitation, Sapienza University, Rome, Italy -
Eur J Phys Rehabil Med. 2019 Feb;55(1):89-94. doi: 10.23736/S1973-9087.18.05314-5. Epub 2018 Aug 29.
The Non-Communicating Children Pain Check List-Revised (NCCPC-R) is a clinical assessment tool used to assess and measure pain in children aged 3 to 18 years, with mental and intellectual disabilities, incapable to speak.
Aim of our study was to test the validity and reliability of the Italian version of the NCCPC-R in children with cognitive impairment, in order to obtain a valid tool for pain assessment in these children.
Prospective observational study.
Pediatric Outpatient of Physical and Rehabilitative Medicine Department, and Pediatrics, Child Neurology and Psychiatry Department, Sapienza University, Rome.
55 non-communicating children, with severe intellectual disability, aged 3-18 years.
The guidelines for "translation, adaptation, and validation of instruments or scales for cross-cultural healthcare research" were used to translate the scale, which was administered by the parents/caregivers twice for 2 consecutive days, in association with NRS (Numerical Rating Scale). The reliability of the scale was evaluated using the intra and inter-class correlation coefficient (ICCs); Cronbach alpha coefficient was used to test the internal validity of the scale; "Receiver Operating Characteristic" (ROC) curves were used to compare pain-free scores with pain scores, determining threshold scores; Pearson correlation between NCCPC-R and NRS values was measured.
The InterCC between the first and the second interviewer at T0 was 0,97, the IntraCC of the first interviewer at T0-T1 was 0,89, showing a high correlation; the Cronbach alpha coefficient at T0 was 0,97, showing a high scale's validity. Pearson correlation between NRS and NCCPC-R values at T0 was 0,54 showing a medium level of agreement (P<0,0001). AUC (area under the curve) obtained by ROC curve at T0 was 0,807 (P=0,001), with sensitivity 95,2 and specificity 55,6, while a T1 AUC was 0,814 (P<0,001), with sensitivity 86,49, specificity 78,57.
The Italian version of NCCPC-R scale could be used to asses pain in non-communicating patients with mental and intellectual disabilities, showing a good correlation when compared to the NRS.
The use of NCCPC-R scale in daily life made parents/caregivers able to discriminate the presence/absence of pain in non-communicating children, based on the scores obtained with the questionnaire.
非交流儿童疼痛检查表修订版（NCCPC-R）是一种临床评估工具，用于评估和测量 3 至 18 岁、有精神和智力障碍、无法说话的儿童的疼痛。
本研究旨在测试意大利版 NCCPC-R 在认知障碍儿童中的有效性和可靠性，以获得一种用于评估这些儿童疼痛的有效工具。
前瞻性观察研究。
罗马萨皮恩扎大学物理康复医学系儿科门诊和儿科学、儿童神经病学和精神病学系。
55 名无法交流的儿童，患有严重智力障碍，年龄在 3 至 18 岁之间。
使用“跨文化医疗保健研究工具或量表的翻译、改编和验证指南”来翻译量表，量表由父母/照顾者在连续两天内两次完成，同时使用 NRS（数字评分量表）。使用组内和组间相关系数（ICC）评估量表的可靠性；Cronbach 阿尔法系数用于测试量表的内部有效性；“接收器工作特征”（ROC）曲线用于比较无痛评分和疼痛评分，确定阈值评分；测量 NCCPC-R 和 NRS 值之间的 Pearson 相关性。
T0 时第一和第二访谈者之间的 InterCC 为 0.97，T0-T1 时第一访谈者的 IntraCC 为 0.89，显示出高度相关性；T0 时 Cronbach 阿尔法系数为 0.97，显示出较高的量表有效性。T0 时 NRS 和 NCCPC-R 值之间的 Pearson 相关性为 0.54，显示出中等水平的一致性（P<0.0001）。ROC 曲线在 T0 时获得的 AUC（曲线下面积）为 0.807（P=0.001），灵敏度为 95.2%，特异性为 55.6%，而 T1 的 AUC 为 0.814（P<0.001），灵敏度为 86.49%，特异性为 78.57%。
意大利版 NCCPC-R 量表可用于评估有精神和智力障碍的无法交流的患者的疼痛，与 NRS 相比具有良好的相关性。
在日常生活中使用 NCCPC-R 量表，使父母/照顾者能够根据问卷获得的分数来区分无法交流的儿童是否存在疼痛。
