Venipuncture pain assessment tools for preschool-aged children

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This study evaluated two novel simplified pain assessment tools for preschool-aged children undergoing blood sampling. These scales demonstrated good validity and feasibility compared with the Faces Pain Scale – Revised, suggesting these simplified pain scales may have a role in clinical practice for children as young as 4 years” Emmott et al (2017).

Abstract:

There is inadequate age-specific data to support the use of current self-report pain scales in 3- and 4-year-old children. Most preschool-aged children also lack the necessary cognitive development to use standard scales. We aimed to evaluate the validity and feasibility of two novel simplified scales (Simplified Faces Pain Scale, S-FPS; Simplified Concrete Ordinal Scale, S-COS) for preschool-aged children. These simplified scales used a two-step self-report method: children were first asked whether they have pain (yes/no); only if yes, then pain intensity was self-reported using a 3-point scale with visual aids signifying mild/moderate/severe.

We recruited 180 3- to 6-year-old children undergoing routine blood collection. Each child was randomly assigned two of three scales – S-FPS, S-COS, Faces Pain Scale-Revised (FPS-R) – to self-report pain before venipuncture, immediately after and 5 minutes later, using both scales at each time-point. Pain was also assessed by observation (FLACC) at each time-point. The ability to discriminate pain from no-pain was improved with S-FPS and S-COS, compared to FPS-R, amongst 4-year-olds, but not 3-year-olds. Correlation with FLACC was moderate to strong and cooperation rates were similar for all self-report scales. The simplified scales can improve and simplify pain assessment for 4-year-olds. Quantitative pain rating remains challenging for 3-year-olds.

PERSPECTIVE: This study evaluated two novel simplified pain assessment tools for preschool-aged children undergoing blood sampling. These scales demonstrated good validity and feasibility compared with the Faces Pain Scale – Revised, suggesting these simplified pain scales may have a role in clinical practice for children as young as 4 years.

Reference:

Emmott, A., West, N., Zhou, G., Dunsmuir, D., Montgomery, C.J., Lauder, G.R. and von Baeyer, C.L. (2017) Validity of Simplified Versus Standard Self-Report Measures of Pain Intensity in Preschool-Aged Children Undergoing Venipuncture. The Journal of Pain. [Epub ahead of print].

doi: 10.1016/j.jpain.2016.12.015.

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