Reliability, validity and clinical utility of three types of pain behavioural observation scales for young children with burns aged 0-5 years

Alette de Jong; Martin Baartmans; Marco Bremer; Rob van Komen; Esther Middelkoop; Wim Tuinebreijer; Nancy van Loey

doi:10.1016/j.pain.2010.06.016

Reliability, validity and clinical utility of three types of pain behavioural observation scales for young children with burns aged 0-5 years

Alette de Jong^*, Martin Baartmans, Marco Bremer, Rob van Komen, Esther Middelkoop, Wim Tuinebreijer, Nancy van Loey

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Pain measurement is a prerequisite for individualized pain management and research into pain interventions. There is a need for reliable and valid pain measures for young children with burns. The aim of this study was to investigate whether the pain observation scale for young children (POCIS), the COMFORT behaviour scale (COMFORT-B) and the nurse observational visual analogue scale (VAS obs) are reliable, valid and clinically useful instruments to measure pain in children with burns aged 0-5 years. Participating trained nurses (N = 102) rated pain of 154 children during hospitalization. Two trained nurses simultaneously assessed pain at fixed intervals by using the previous mentioned measures. Cronbach's alpha for POCIS was .87 for background and .89 for procedural pain. Intraclass Correlation Coefficients (ICCs) were .75 for background and .81 for procedural pain. COMFORT-B observations yielded Cronbach's alpha of .77 for background and .86 for procedural pain and ICCs of .83 for background and .82 for procedural pain. The VAS ohs resulted in ICCs of .55 for background and .60 for procedural pain. Correlation coefficient between POCIS and COMFORT-B was .79 (p <.01), Standardized response mean was 1.04 for both PODS and COMFORT-B. Background pain measured with POCIS and COMFORT-B was lower than procedural pain (p <.001). Nurses found POCIS easier and quicker to use, but COMFORT-B was found to indicate pain more accurately. Both POCIS and COMFORT-B are reliable, valid and practical scales for pain measurement in young children with burns and can be used in practice and research. The VAS ohs was found to be unreliable. (C) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Original language	English
Pages (from-to)	561-567
Number of pages	7
Journal	Pain
Volume	150
Issue number	3
DOIs	https://doi.org/10.1016/j.pain.2010.06.016
Publication status	Published - Sept 2010
Externally published	Yes

Funding

The authors would like to thank all nurses from the Dutch burn centres, Mrs. O. Duijndam, Mrs. M. Fuchs, Mrs. C. Hulsmann, Mrs. N. Kruger, Mrs. J. Leeman, Mrs. A. Nijman, Mrs. I. Oen, Mrs. H. Renkema, Mrs. C. Roerhorst and Mr. R. Scheffer for their participation, support and advices. They would also like to thank Prof. dr. R. de Vet for her statistical advice. This study was supported by a Grant (06.301) from the Dutch Burn Foundation, Beverwijk, The Netherlands.

Keywords

Burns
Children
Pain measurement
Behaviour
Observation
VISUAL ANALOG SCALE
POSTOPERATIVE PAIN
3-YEAR-OLD INFANTS
COMFORT SCALE
NURSES
RATINGS
SURGERY
CARE

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10.1016/j.pain.2010.06.016

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@article{6222718d40f34a8ea8d47907e03f427b,

title = "Reliability, validity and clinical utility of three types of pain behavioural observation scales for young children with burns aged 0-5 years",

abstract = "Pain measurement is a prerequisite for individualized pain management and research into pain interventions. There is a need for reliable and valid pain measures for young children with burns. The aim of this study was to investigate whether the pain observation scale for young children (POCIS), the COMFORT behaviour scale (COMFORT-B) and the nurse observational visual analogue scale (VAS obs) are reliable, valid and clinically useful instruments to measure pain in children with burns aged 0-5 years. Participating trained nurses (N = 102) rated pain of 154 children during hospitalization. Two trained nurses simultaneously assessed pain at fixed intervals by using the previous mentioned measures. Cronbach's alpha for POCIS was .87 for background and .89 for procedural pain. Intraclass Correlation Coefficients (ICCs) were .75 for background and .81 for procedural pain. COMFORT-B observations yielded Cronbach's alpha of .77 for background and .86 for procedural pain and ICCs of .83 for background and .82 for procedural pain. The VAS ohs resulted in ICCs of .55 for background and .60 for procedural pain. Correlation coefficient between POCIS and COMFORT-B was .79 (p <.01), Standardized response mean was 1.04 for both PODS and COMFORT-B. Background pain measured with POCIS and COMFORT-B was lower than procedural pain (p <.001). Nurses found POCIS easier and quicker to use, but COMFORT-B was found to indicate pain more accurately. Both POCIS and COMFORT-B are reliable, valid and practical scales for pain measurement in young children with burns and can be used in practice and research. The VAS ohs was found to be unreliable. (C) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.",

keywords = "Burns, Children, Pain measurement, Behaviour, Observation, VISUAL ANALOG SCALE, POSTOPERATIVE PAIN, 3-YEAR-OLD INFANTS, COMFORT SCALE, NURSES, RATINGS, SURGERY, CARE",

author = "{de Jong}, Alette and Martin Baartmans and Marco Bremer and {van Komen}, Rob and Esther Middelkoop and Wim Tuinebreijer and {van Loey}, Nancy",

year = "2010",

month = sep,

doi = "10.1016/j.pain.2010.06.016",

language = "English",

volume = "150",

pages = "561--567",

journal = "Pain",

issn = "0304-3959",

publisher = "Lippincott Williams and Wilkins",

number = "3",

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TY - JOUR

T1 - Reliability, validity and clinical utility of three types of pain behavioural observation scales for young children with burns aged 0-5 years

AU - de Jong, Alette

AU - Baartmans, Martin

AU - Bremer, Marco

AU - van Komen, Rob

AU - Middelkoop, Esther

AU - Tuinebreijer, Wim

AU - van Loey, Nancy

PY - 2010/9

Y1 - 2010/9

N2 - Pain measurement is a prerequisite for individualized pain management and research into pain interventions. There is a need for reliable and valid pain measures for young children with burns. The aim of this study was to investigate whether the pain observation scale for young children (POCIS), the COMFORT behaviour scale (COMFORT-B) and the nurse observational visual analogue scale (VAS obs) are reliable, valid and clinically useful instruments to measure pain in children with burns aged 0-5 years. Participating trained nurses (N = 102) rated pain of 154 children during hospitalization. Two trained nurses simultaneously assessed pain at fixed intervals by using the previous mentioned measures. Cronbach's alpha for POCIS was .87 for background and .89 for procedural pain. Intraclass Correlation Coefficients (ICCs) were .75 for background and .81 for procedural pain. COMFORT-B observations yielded Cronbach's alpha of .77 for background and .86 for procedural pain and ICCs of .83 for background and .82 for procedural pain. The VAS ohs resulted in ICCs of .55 for background and .60 for procedural pain. Correlation coefficient between POCIS and COMFORT-B was .79 (p <.01), Standardized response mean was 1.04 for both PODS and COMFORT-B. Background pain measured with POCIS and COMFORT-B was lower than procedural pain (p <.001). Nurses found POCIS easier and quicker to use, but COMFORT-B was found to indicate pain more accurately. Both POCIS and COMFORT-B are reliable, valid and practical scales for pain measurement in young children with burns and can be used in practice and research. The VAS ohs was found to be unreliable. (C) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

AB - Pain measurement is a prerequisite for individualized pain management and research into pain interventions. There is a need for reliable and valid pain measures for young children with burns. The aim of this study was to investigate whether the pain observation scale for young children (POCIS), the COMFORT behaviour scale (COMFORT-B) and the nurse observational visual analogue scale (VAS obs) are reliable, valid and clinically useful instruments to measure pain in children with burns aged 0-5 years. Participating trained nurses (N = 102) rated pain of 154 children during hospitalization. Two trained nurses simultaneously assessed pain at fixed intervals by using the previous mentioned measures. Cronbach's alpha for POCIS was .87 for background and .89 for procedural pain. Intraclass Correlation Coefficients (ICCs) were .75 for background and .81 for procedural pain. COMFORT-B observations yielded Cronbach's alpha of .77 for background and .86 for procedural pain and ICCs of .83 for background and .82 for procedural pain. The VAS ohs resulted in ICCs of .55 for background and .60 for procedural pain. Correlation coefficient between POCIS and COMFORT-B was .79 (p <.01), Standardized response mean was 1.04 for both PODS and COMFORT-B. Background pain measured with POCIS and COMFORT-B was lower than procedural pain (p <.001). Nurses found POCIS easier and quicker to use, but COMFORT-B was found to indicate pain more accurately. Both POCIS and COMFORT-B are reliable, valid and practical scales for pain measurement in young children with burns and can be used in practice and research. The VAS ohs was found to be unreliable. (C) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

KW - Burns

KW - Children

KW - Pain measurement

KW - Behaviour

KW - Observation

KW - VISUAL ANALOG SCALE

KW - POSTOPERATIVE PAIN

KW - 3-YEAR-OLD INFANTS

KW - COMFORT SCALE

KW - NURSES

KW - RATINGS

KW - SURGERY

KW - CARE

U2 - 10.1016/j.pain.2010.06.016

DO - 10.1016/j.pain.2010.06.016

M3 - Article

C2 - 20619968

SN - 0304-3959

VL - 150

SP - 561

EP - 567

JO - Pain

JF - Pain

IS - 3

ER -

Reliability, validity and clinical utility of three types of pain behavioural observation scales for young children with burns aged 0-5 years

Abstract

Funding

Keywords

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