Child Health Nursing, Course of Nursing Science, Graduate School of Medicine, Mie University, Tsu, Mie, Japan.
Department of Pediatrics, National Hospital Organization Mie Hospital, Tsu, Mie, Japan.
PLoS One. 2020 Dec 22;15(12):e0243566. doi: 10.1371/journal.pone.0243566. eCollection 2020.
Children with severe motor and intellectual disabilities experience chronic pain but cannot communicate verbally. However, no Japanese tool currently exists for assessing pain in this population. This study aimed to develop and evaluate the reliability and validity of a Japanese version of the Paediatric Pain Profile, which is a behavioral rating scale to assess pain in children with severe neurological disabilities. The sample comprised 30 children with severe motor and intellectual disabilities at three hospitals in Japan. Three specialist nurses rated low and high pain video scenes of the children (twice at 1-week intervals) using the Face, Legs, Activity, Cry, Consolability behavioral scale and a translated Japanese version of the Paediatric Pain Profile. On the basis of their ratings, we calculated the internal consistency, test-retest reliability, and intra- and inter-observer reliabilities of the Paediatric Pain Profile. Additionally, we assessed concurrent validity using the Face, Legs, Activity, Cry, Consolability behavioral scale and construct validity using low versus high pain scenes. Both internal consistency (low pain: alpha = 0.735; high pain: alpha = 0.928) and test-retest reliability (r = 0.846) of the Japanese version of the Paediatric Pain Profile were good. Intra-observer reliability was substantial (r = 0.748), whereas inter-observer reliability was only moderate (r = 0.529). However, the concurrent validity with Face, Legs, Activity, Cry, Consolability scores was good (r = 0.629) and construct validity was confirmed (p < 0.001). We confirmed the validity of the Japanese version of the Paediatric Pain Profile, but reliable pain assessment may require repeated ratings by the same person. To accurately assess pain in children with severe motor and intellectual disabilities, healthcare staff must be properly trained and become more skilled in using the Japanese version of the Paediatric Pain Profile.
患有严重运动和智力残疾的儿童会经历慢性疼痛，但无法进行口头表达。然而，目前日本还没有专门用于评估此类人群疼痛的工具。本研究旨在开发和评估儿童疼痛行为评估量表（Paediatric Pain Profile）的日语版的可靠性和有效性，该量表是一种用于评估严重神经发育障碍儿童疼痛的行为评定量表。该样本包括日本三家医院的 30 名患有严重运动和智力残疾的儿童。三名专科护士使用面部、腿部、活动、哭泣、安抚行为量表（Face, Legs, Activity, Cry, Consolability behavioral scale）和翻译后的 Paediatric Pain Profile 日语版两次（间隔 1 周）对儿童的低强度和高强度疼痛视频场景进行评分。根据他们的评分，我们计算了 Paediatric Pain Profile 的内部一致性、测试-重测信度以及组内和组间信度。此外，我们还使用面部、腿部、活动、哭泣、安抚行为量表评估了同时效度，使用低强度与高强度疼痛场景评估了结构效度。Paediatric Pain Profile 日语版的内部一致性（低强度疼痛：alpha = 0.735；高强度疼痛：alpha = 0.928）和测试-重测信度（r = 0.846）均良好。组内信度较高（r = 0.748），而组间信度仅为中等（r = 0.529）。然而，与面部、腿部、活动、哭泣、安抚行为评分的同时效度良好（r = 0.629），且结构效度得到了验证（p < 0.001）。我们确认了 Paediatric Pain Profile 日语版的有效性，但可靠的疼痛评估可能需要由同一人进行重复评分。为了准确评估患有严重运动和智力残疾的儿童的疼痛，医疗保健人员必须接受适当的培训，并提高使用 Paediatric Pain Profile 日语版的技能。
