Postoperative use of pediatric pain scales: children's self-report versus nurse assessment of pain intensity and affect.

The purpose was to examine nurses' use of pediatric pain scales and to compare their estimate of the child's pain intensity and affect with the child's self-report. The Analog Chromatic Continuous Scale (ACCS) was used for pain intensity and the McGrath Affective Faces Scale (MAFS) for pain affect. Self-report of pain was obtained from 124 hospitalized postoperative children aged 5 to 17 years and compared with estimates of 44 pediatric nurses randomly assigned to either an experimental or control group. Experimental nurses used the ACCS and MAFS to obtain pain ratings whereas control nurses made estimates according to their customary method of assessment. Findings revealed that only 36% of the nurses had at any time used a pediatric pain scale. Correlations between the experimental nurses' ratings and the child's self-report were significantly higher than the control nurses' estimates and the child's self-report. The correlation between the child's self-report of pain intensity on the ACCS and of affect on the MAFS was r = .612, suggesting that nurses' use of both an intensity and affect pediatric pain scale would more accurately reflect the child's pain experience.