Examination of Different Pain Scales

Research Article

Ann Yoga Phys Ther. 2016; 1(3): 1016.

Examination of Different Pain Scales

Esra DH¹* and Yildirim SA²

¹Department of Physiotherapy and Rehabilitation, Mustafa Kemal University, Turkey

²Department of Physical Therapy and Rehabilitation, Hacettepe University, Turkey

*Corresponding author: Esra DOGRU HUZMELI, Department of Physiotherapy and Rehabilitation, School of Physical Therapy and Rehabilitation, Mustafa Kemal University, Hatay, Turkey

Received: December 05, 2016; Accepted: December 19, 2016; Published: December 20, 2016

Abstract

Aim: There are many pain assessment techniques, and the best scale is not clear. The purpose of this study was to examine a self-report questionnaire, observational scale, and verbal scale; describe physiotherapist–parent– children’s postoperative pain assessment correlation; and address the preference and clinical utility of validated pain scale.

Methods: The participants in the study consisted of 101 children (3–18 years, 75 boys and 26 girls). The assessment was made in the postoperative 30th minute when they were fully awake. Before the assessment, children were asked their demographic datas. Pain was assessed using four validated and standardized pain scales: Oucher, Face, Legs, Activity, Cry and Consolability (FLACC), the Faces Pain Scale, and the Verbal Rating Scale.

Results: To assess the correlation between four pain scales, Spearmen correlation calculations were used. Oucher has a positive and strong correlation with the Verbal Rating Scale (VRS) (0.727) and Faces Pain Scale (FPS) (0.757). VRS has a strong and positive correlation with FPS (0.744). FLACC has a moderate and positive correlation with FPS and Oucher, but a weak correlation with VRS. Oucher was the most preferred scale by the children. Fourteen children could not decide which scale they preferred.

Discussion: Oucher was the most preferred scale by the children and had a uniformly increasing relationship with FPS and VRS. This finding has implications for research on pain management using Oucher, which was a reliable and preferred scale in children. It was found they in case the child could not define pain, parents’ assessments were reliable.

Keywords: Pain; Children; Oucher; Faces pain scale; FLACC

Introduction

Pain is an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life [1]. Babies and people with cognitive deficits feel pain without being capable of describing the pain that they feel. All children normally experience pain from different sources. Pain following surgery in infants and children delays healing and increases morbidity [2-5].

In 1984, Ross, et al. the measurement and evaluation of pain in infants and children had been almost completely ignored claimed [5]. Some developments must have been made during the intervening period, since the past 20 years have brought realization to the clinicians involved in the treatment of children that pain is a real phenomenon in children. There have been significant improvements in awareness, assessment, and treatment of children’s pain in the last 20 years [5-9].

The accurate measurement of pain in children is essential for planning treatment [5]. A large number of measurement techniques have been devised to measure pain in children. These include observational checklists, physiological responses, self-report questionnaires, selections from lists of descriptors, selection from interval scales, Visual Analog Scales (VAS), and projective techniques.

The psychological measures are all based on either domain sampling or psychophysical scaling [6-9]. Thus, there are many pain assessment techniques, and the best scale is not clear. The evaluator should choose tools that are valid and reliable, as well as tools that are informative about children’s pain experiences [6,9-11].

Parents and children’s assessments of children’s pain have been very similar according to earlier studies. Thus, it can be assumed that parents know their children well and can assess their pain in a reliable way [6,12,13].

A perfectly reliable and valid measurement of pain intensity is unattainable. Specifically, a gold-standard pain scale for use with all children is not available.

The purpose of this study was to 1. Examine self-report questionnaire, observational scale and verbal scale and 2. To describe physiotherapist-parent-children’s postoperative pain assessment correlation and 3. To address the preference and clinical utility of validated pain scales.

Methods

The study was conducted at Kutahya State Hospital. The participants in the study consisted of 101 children (3–18 years, 75 boys and 26 girls) (Table 1). Their demographic datas and operation methods were questioned. Ethical clearance was obtained from the Hacettepe University Health Institute’s Ethics Committee, and written informed consent was obtained from parents prior to enrollment in the study. Children who have mental, vision, hearing, neurological, or developmental problems; complications after acute surgery and whose native language was not Turkish were excluded from the study.