Development and preliminary validation of a postoperative pain measure for parents
Development and preliminary validation of a postoperative pain measure for parents
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DOI：
10.1016/s0304-3959(96)03209-5
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发表时间：
1996-12-01
期刊：
影响因子：
7.4
通讯作者：
Finley, GA
中科院分区：
文献类型：
--
作者：
Chambers, CT;Reid, GJ;Finley, GA
父母现在主要负责在家里评估和治疗他们孩子在小手术后的疼痛。虽然一些研究表明，父母低估了他们的孩子手术后的疼痛，没有行为措施存在，以帮助父母在疼痛评估。父母术后疼痛测量是根据父母报告的用于评估其孩子疼痛的线索（例如，食欲，活动水平的变化）开发的。本研究的目的是发展和验证这一措施，通过检查之间的关系，父母报告的儿童行为和儿童疼痛。受试者为110名7-12岁的儿童（56.4%为男性），他们在三级儿童医院及其父母接受日间手术。父母和孩子完成了术后2天的疼痛日记。孩子们对他们的疼痛和情绪困扰进行评分，父母则对清单中存在或不存在的特定行为进行评分。在第1天，29个行为项目中的每一个与儿童评定的疼痛之间进行相关性分析; 14个相关性小于0.30的项目被删除。其余15个项目进行了主轴因子分析。单因素解决方案是数据的最佳拟合。然后将这些项目相加，得出总分（满分15分）。内部一致性的措施和相关性与儿童疼痛的信度在术后两天都很高。儿童疼痛和情绪困扰中度相关。术后父母的术后疼痛测量也与术后两天的儿童情绪困扰呈正相关。随着儿童疼痛评分从第1天到第2天下降，行为测量的评分也下降。父母术后疼痛测量成功区分了接受无/低疼痛手术的儿童和接受中度至高度疼痛手术的儿童。儿童年龄或性别的行为测量得分没有显着差异。使用15分中的6分作为临界值，该测量在选择报告临床显著疼痛水平的儿童时显示出极好的灵敏度（> 80%）和特异性（> 80%）。本研究提供了初步证据，证明父母术后疼痛测量可作为7-12岁儿童术后的有效评估工具。它是内部一致的，并与儿童评定的疼痛密切相关。未来的研究应该探索使用这种措施与一个年轻的样本和儿童发育迟缓。
Parents are now primarily responsible for the at home assessment and treatment of their children's pain following minor surgery. Although some research has suggested that parents underestimate their children's pain following surgery, no behavioral measure exists to assist parents in pain assessment. The Postoperative Pain Measure for Parents was developed based on cues parents reported using to assess their children's pain (e.g, changes in appetite, activity level). The purpose of the present study was to develop and validate this measure by examining the relation between parent-report of child behaviors and child-rated pain. Subjects were 110 children (56.4% male) aged 7-12 years undergoing day surgery at a tertiary-care children's hospital and their parents. Parents and children completed a pain diary for the 2 days following surgery. Children rated their pain and emotional distress and parents rated the presence or absence of specific behaviors from a checklist. Correlations were conducted between each of the 29 behavioral items and child-rated pain on Day 1; 14 items with correlations less than 0.30 were dropped. The remaining 15 items were subjected to a principal axis factor analysis. A one-factor solution was the best fit for the data. The items were then summed to yield a total score out of 15. Internal consistency reliabilities for the measure and correlations with child-rated pain were high on both days following surgery. Child-rated pain and emotional distress were moderately correlated. The Postoperative Pain Measure for Parents was also positively correlated with child-rated emotional distress on both days following surgery. As child-rated pain decreased from Day 1 to Day 2, so did scores on the behavioral measure. The Postoperative Pain Measure for Parents was successful in discriminating between children who had undergone no/low pain surgeries and children who had undergone moderate to high pain surgeries. There were no significant differences in scores on the behavioral measure for child age or sex. Using a cut-off score of six out of 15, the measure showed excellent sensitivity (> 80%) and specificity (> 80%) in selecting children who reported clinically significant levels of pain. This study provides preliminary evidence for the use of the Postoperative Pain Measure for Parents as a valid assessment tool with children between the ages of 7-12 years following day surgery. It is internally consistent and strongly related to child-rated pain. Future research should explore the use of this measure with a younger sample and children with developmental delays.