Electronic and paper versions of a faces pain intensity scale: concordance and preference in hospitalized children

Chantal Wood, Carl L von Baeyer, Sylvain Falinower, Dominique Moyse, Daniel Annequin, Valérie Legout, Chantal Wood, Carl L von Baeyer, Sylvain Falinower, Dominique Moyse, Daniel Annequin, Valérie Legout

Abstract

Background: Assessment of pain in children is an important aspect of pain management and can be performed by observational methods or by self-assessment. The Faces Pain Scale-Revised (FPS-R) is a self-report tool which has strong positive correlations with other well established self-report pain intensity measures. It has been recommended for measuring pain intensity in school-aged children (4 years and older). The objective of this study is to compare the concordance and the preference for two versions, electronic and paper, of the FPS-R, and to determine whether an electronic version of the FPS-R can be used by children aged 4 and older.

Methods: The study is an observational, multicenter, randomized, cross-over, controlled, open trial. Medical and surgical patients in two pediatric hospitals (N=202, age 4-12 years, mean age 8.3 years, 58% male) provided self-reports of their present pain using the FPS-R on a personal digital assistant (PDA) and on a paper version. Paper and electronic versions of the FPS-R were administered by a nurse in a randomized order: half the patients were given the PDA version first and the other half the paper version first. The time between the administrations was planned to be less than 30 minutes but not simultaneous. Two hundred and thirty-seven patients were enrolled; 35 were excluded from analysis because of misunderstanding of instructions or abnormal time between the two assessments.

Results: Final population for analysis comprised 202 children. The overall weighted Kappa was 0.846 (95%CI: 0.795; 0.896) and the Spearman correlation between scores on the two versions was rs=0.911 (p<0.0001). The mean difference of pain scores was less than 0.1 out of 10, which was neither statistically nor clinically significant; 83.2% of children chose the same face on both versions of the FPS-R. Preference was not modified by order, sex, age, hospitalization unit (medical or surgical units), or previous analgesics. The PDA was preferred by 87.4% of the children who expressed a preference.

Conclusion: The electronic version of the FPS-R can be recommended for use with children aged 4 to 12, either in clinical trials or in hospitals to monitor pain intensity.

Figures

Figure 1
Figure 1
Electronic version of Faces Pain Scale. Electronic version of Faces Pain Scale - Revised, using PDA, Palm Zire 71™. Instructions and procedure are in text. The PDA screen measures 55 × 55 mm. The image of the face measures 35 × 25 mm. Faces Pain Scale - Revised: copyright ©2001, International Association for the Study of Pain, reproduced with permission. Palm® software: Copyright ©2004.
Figure 2
Figure 2
Distribution of score intensity ratings. Percentages of score intensity ratings are computed on the overall population (n = 202).

References

    1. Dale O, Hagen KB. Despite technical problems personal digital assistants outperform pen and paper when collecting patient diary data. J Clin Epidemiol. 2007;60(1):8–17. doi: 10.1016/j.jclinepi.2006.04.005.
    1. Lane SJ, Heddle NM, Arnold E, Walker I. A review of randomized controlled trials comparing the effectiveness of hand held computers with paper methods for data collection. BMC Med Inform Decis Mak. 2006;6:23. doi: 10.1186/1472-6947-6-23.
    1. Stinson JN. Improving the assessment of pediatric chronic pain: harnessing the potential of electronic diaries. Pain Res Manag. 2009;14(1):59–64.
    1. Junker U, Freynhagen R, Langler K, Gockel U, Schmidt U, Tolle TR, Baron R, Kohlmann T. Paper versus electronic rating scales for pain assessment: a prospective, randomised, cross-over validation study with 200 chronic pain patients. Curr Med Res Opin. 2008;24(6):1797–1806. doi: 10.1185/03007990802121059.
    1. Marceau LD, Link C, Jamison RN, Carolan S. Electronic diaries as a tool to improve pain management: is there any evidence? Pain Med. 2007;8(Suppl 3):S101–109.
    1. Morren M, van Dulmen S, Ouwerkerk J, Bensing J. Compliance with momentary pain measurement using electronic diaries: a systematic review. Eur J Pain. 2009;13(4):354–365. doi: 10.1016/j.ejpain.2008.05.010.
    1. Price DD, Patel R, Robinson ME, Staud R. Characteristics of electronic visual analogue and numerical scales for ratings of experimental pain in healthy subjects and fibromyalgia patients. Pain. 2008;140(1):158–166. doi: 10.1016/j.pain.2008.07.028.
    1. Roelofs J, Peters ML, Patijn J, Schouten EG, Vlaeyen JW. Electronic diary assessment of pain-related fear, attention to pain, and pain intensity in chronic low back pain patients. Pain. 2004;112(3):335–342. doi: 10.1016/j.pain.2004.09.016.
    1. Falinower S, Martret P, Lombart B, Reti E, Krause D, Annequin D. Auto-évaluation de la douleur aiguë chez l'enfant. Utilisation de l'"échelle des visages" en version électronique sur micro-ordinateur de poche (PDA) PalmOneTM [Self report of acute pain by children using an electronic version of the Faces Pain Scale - Revised on the PalmOne data assistant] Douleurs. 2004;5(5):249–257.
    1. Fanciullo GJ, Cravero JP, Mudge BO, McHugo GJ, Baird JC. Development of a new computer method to assess children's pain. Pain Med. 2007;8(Suppl 3):S121–128.
    1. Palermo TM, Valenzuela D, Stork PP. A randomized trial of electronic versus paper pain diaries in children: impact on compliance, accuracy, and acceptability. Pain. 2004;107(3):213–219. doi: 10.1016/j.pain.2003.10.005.
    1. Stinson JN, Petroz GC, Tait G, Feldman BM, Streiner D, McGrath PJ, Stevens BJ. e-Ouch: usability testing of an electronic chronic pain diary for adolescents with arthritis. Clin J Pain. 2006;22(3):295–305. doi: 10.1097/01.ajp.0000173371.54579.31.
    1. Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain. 2001;93(2):173–183. doi: 10.1016/S0304-3959(01)00314-1.
    1. Spagrud LJ, Piira T, Von Baeyer CL. Children's self-report of pain intensity. Am J Nurs. 2003;103(12):62–64. doi: 10.1097/00000446-200312000-00020.
    1. Champion GD, Goodenough B, von Baeyer CL, Thomas W. In: Measurement of Pain in Infants and Children. Finley GA, McGrath PJ, editor. Seattle: IASP Press; 1998. Measurement of pain by self-report; pp. 123–160.
    1. Tomlinson D, von Baeyer CL, Stinson JN, Sung L. A systematic review of faces scales for the self-report of pain intensity in children. Pediatrics. 2010;126(5):e1168–1198. doi: 10.1542/peds.2010-1609.
    1. Stinson JN, Kavanagh T, Yamada J, Gill N, Stevens B. Systematic review of yhe psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. Pain. 2006;125(1-2):143–57. doi: 10.1016/j.pain.2006.05.006.
    1. McGrath PJ, Walco GA, Turk DC, Dworkin RH, Brown MT, Davidson K, Eccleston C, Finley GA, Goldschneider K, Haverkos L, Hertz SH, Ljungman G, Palermo T, Rappaport BA, Rhodes T, Schechter N, Scott J, Sethna N, Svensson OK, Stinson J, von Baeyer CL, Walker L, Weisman S, White RE, Zajicek A, Zeltzer L. Core Outcome Domains and Measures for Pediatric Acute and Chronic/Recurrent Pain Clinical Trials: PedIMMPACT Recommendations. J Pain. 2008;9(9):771–83. doi: 10.1016/j.jpain.2008.04.007.
    1. von Baeyer CL. Children's self-report of pain intensity: what we know, where we are headed. Pain Res Manag. 2009;14(1):39–45.
    1. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–174. doi: 10.2307/2529310.
    1. Powell CV, Kelly AM, Williams A. Determining the minimum clinically significant difference in visual analog pain score for children. Ann Emerg Med. 2001;37(1):28–31. doi: 10.1067/mem.2001.111517.
    1. Gulur P, Rodi SW, Washington TA, Cravero JP, Fanciullo GJ, McHugo GJ, Baird JC. Computer Face Scale for Measuring Pediatric Pain and Mood. J Pain. 2009;10(2):173–9. doi: 10.1016/j.jpain.2008.08.005. Epub Nov 17, 2008.
    1. Stinson JN, Petroz GC, Stevens BJ, Feldman BM, Streiner D, McGrath PJ, Gill N. Working out the kinks: testing the feasibility of an electronic pain diary for adolescents with arthritis. Pain Res Manag. 2008;13(5):375–382.
    1. Menachemi N, Ettel DL, Brooks RG, Simpson L. Charting the use of electronic health records and other information technologies among child health providers. BMC Pediatr. 2006;6:21. doi: 10.1186/1471-2431-6-21.
    1. Keogh E, Rosser BA, Eccleston C. e-Health and chronic pain management: current status and developments. Pain. 2010;151:8–21.
    1. Stone AA, Broderick JE. Real-time data collection for pain: appraisal and current status. Pain Medecine. 2007;8(Suppl 3):S85–93.
    1. von Baeyer CL. Children's self-reports of pain intensity: scale selection, limitations and interpretation. Pain Res Manag. 2006;11(3):157–162.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever