The revised FLACC observational pain tool: improved reliability and validity for pain assessment in children with cognitive impairment
PedPal Lit
BACKGROUND: Difficulty with pain assessment in individuals who cannot self-report their pain poses a significant barrier to effective pain management. However, available assessment tools lack consistent reliability as pain measures in children with cognitive impairment (CI). This study evaluated the validity and reliability of the revised and individualized Face Legs Activity Cry and Consolability (FLACC) behavioral pain assessment tool in children with CI. METHODS: Children with CI scheduled for elective surgery were studied. The FLACC was revised to include specific descriptors and parent-identified, unique behaviors for individual children. The child's ability to self-report pain was evaluated. Postoperatively, two nurses scored pain using the revised FLACC scale before and after analgesic administration, and, children self-reported a pain score, if able. Observations were videotaped and later viewed by experienced nurses blinded to analgesic administration. RESULTS: Eighty observations were recorded in 52 children aged 4-19 years. Twenty-one parents added individualized pain behaviors to the revised FLACC. Interrater reliability was supported by excellent intraclass correlation coefficients (ICC, ranging from 0.76 to 0.90) and adequate kappa statistics (0.44-0.57). Criterion validity was supported by the correlations between FLACC, parent, and child scores (rho = 0.65-0.87; P < 0.001). Construct validity was demonstrated by the decrease in FLACC scores following analgesic administration (6.1 +/- 2.6 vs 1.9 +/- 2.7; P < 0.001). CONCLUSIONS: Findings support the reliability and validity of the FLACC as a measure of pain in children with CI.
2006
Malviya S; Voepel-Lewis T; Burke C; Merkel S; Tait AR
Paediatr Anaesth
2006
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
Difficult pain assessment and lack of clinician knowledge are ongoing barriers to effective pain management in children with cognitive impairment
PedPal Lit
2005
Malviya S; Voepel-Lewis T; Merkel S; Tait AR
Acute Pain
2005
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.acpain.2005.01.002" target="_blank" rel="noreferrer">10.1016/j.acpain.2005.01.002</a>