Clinical validation of the paediatric pain profile
Child; Female; Humans; Male; Sensitivity and Specificity; Analgesia; Reproducibility of Results; Communication Disorders; adolescent; Preschool; Non-U.S. Gov't; Research Support; infant; Q3 Literature Search; Nervous System Diseases/complications; disabled children; Pain Measurement/methods; Operative; Surgical Procedures
The Paediatric Pain Profile (PPP) is a 20-item behaviour rating scale designed to assess pain in children with severe neurological disability. We assessed the validity and reliability of the scale in 140 children (76 females, mean age 9 years 11 months, SD 4 years 7 months; range 1 to 18 years), unable to communicate through speech or augmentative communication. Parents used the PPP to rate retrospectively their child's behaviour when 'at their best' and when in pain. To assess interrater reliability, two raters concurrently observed and individually rated each child's behaviour. To assess construct validity and responsiveness of the scale, behaviour of 41 children was rated before and for four hours after administration of an 'as required' analgesic. Behaviour of 30 children was rated before surgery and for five days after. Children had significantly higher scores when reported to have pain than 'at their best' and scores increased in line with global evaluations of pain. Internal consistency ranged from 0.75 to 0.89 (Cronbach's alpha) and interrater reliability from 0.74 to 0.89 (intraclass correlation). Sensitivity (1.00) and specificity (0.91) were optimized at a cut-off of 14/60. PPP score was significantly greater before administration of the analgesic than after (paired-sample t-tests, p<0.001). Though there was no significant difference in mean pre- and postoperative scores, highest PPP score occurred in the first 24 hours after surgery in 14 (47%) children. Results suggest that the PPP is reliable and valid and has potential for use both clinically and in intervention research.
2004
Hunt A; Goldman A; Seers K; Crichton N; Mastroyannopoulou K; Moffat V; Oulton K; Brady M
Developmental Medicine And Child Neurology
2004
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1017/s0012162204000039" target="_blank" rel="noreferrer">10.1017/s0012162204000039</a>
Development of the paediatric pain profile: role of video analysis and saliva cortisol in validating a tool to assess pain in children with severe neurological disability
Child; Female; Humans; Male; Reproducibility of Results; Child Behavior; adolescent; Preschool; Biomarkers of Pain; Hydrocortisone/metabolism; Nervous System Diseases/complications/metabolism/psychology; Pain Measurement/methods; Pain/etiology/metabolism/psychology; Saliva/metabolism; Videotape Recording
The Paediatric Pain Profile (PPP) is a 20-item behavior-rating scale designed to assess pain in children with severe to profound neurological impairment. Three raters independently used the PPP to rate behavior of 29 children (mean age 9.6, SD 5.8) filmed during everyday morning activities. The validation process included assessment of interrater reliability and exploration of the relationship of PPP scores with saliva cortisol concentration. There was substantial agreement between raters. The PPP showed strong association with global pain assessments and differentiated between preselected high- and low-pain groups. PPP score showed moderate correlation with saliva cortisol concentration, but a single child explained the strength of the relationship and overall, saliva cortisol concentrations appeared low. The data provide additional evidence that the PPP is a reliable and valid instrument for pain assessment in neurologically impaired children. Cortisol levels are not a useful criterion for pain in this population and further study of cortisol response to stress/pain in children with severe neurological impairments is needed.
2007
Hunt A; Wisbeach A; Seers K; Goldman A; Crichton N; Perry L; Mastroyannopoulou K
Journal Of Pain And Symptom Management
2007
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.jpainsymman.2006.08.011" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2006.08.011</a>