Clinical validation of the multidimensional assessment of pain scale
Clinical validation of the multidimensional assessment of pain scale
复制标题
DOI：
10.1111/j.1460-9592.2007.02325.x
复制
发表时间：
2007-12-01
影响因子：
1.7
通讯作者：
Abu-Saad, Huda Huijer
中科院分区：
文献类型：
--
作者：
Ramelet, Anne-Sylvie;Rees, Nancy Willie;Abu-Saad, Huda Huijer
背景：多维评估疼痛等级(MAP)是用来测量危重患儿术后疼痛的。在初步的心理测量学测试之后，需要对这个5类10分量表进行额外的验证。本文报告了一项旨在评估MAP的临床有效性和实用性的后续验证研究的结果。方法：MAP包括五个类别，在西澳大利亚一家三级转诊医院对19名0至31个月的术后危重儿童(94%插管)进行了方便样本的止痛药反应测试。使用MAP、面腿活动哭闹可融合性(FLACC)和视觉模拟尺度观察者(VAS(OBS))检验收敛效度和并发效度。并对MAP的临床应用价值进行了评价。结果：注射大剂量吗啡后，疼痛多维评定量表评分下降4分(占总分的40%)(P<；0.001)。MAP和Flacc以及MAP和VAS(OBS)之间的一致测量表明，测量误差的风险很小。如果删除生理项目(Cronbach‘s Alpha为0.79-0.64)，MAP的内部一致性将会提高。然而，在注射强效吗啡后15、30和60分钟，心率、收缩压、平均动脉压和舒张压的实际值显著降低(7-14%)(P<；0.001)。MAP也证明了临床上的可行性。结论：本研究表明，类似于Flacc和VAS(OBS)的MAP在解救吗啡后也有类似的下降。MAP的修订可以推荐给临床应用。
Background: The Multidimensional Assessment Pain Scale (MAPS), was developed to measure postoperative pain in critically ill preverbal children. Following preliminary psychometric testing, additional validation of this 5-category 10-point scale was required. This article reports the results of a follow-up validation study that aimed to evaluate the clinical validity and utility of the MAPS. Methods: The MAPS includes five categories and was tested in response to analgesics in a convenience sample of 19 postoperative critically ill children (94% intubated) aged between 0 and 31 months at a tertiary referral hospital in Western Australia. Convergent and concurrent validity was tested using the MAPS, Faces Legs Activity Cry Consolability (FLACC), and Visual Analog Scale observer (VAS(obs)). Clinical utility of the MAPS was also evaluated. Results: The Multidimensional Assessment Pain Scale scores decreased significantly by four points (40% of total score) after the administration of a potent dose of morphine (P < 0.001). Agreement measurements between MAPS and FLACC and MAPS and VAS(obs) showed that the risk of measurement error was small. Internal consistency of the MAPS would improve if the physiologic item was deleted (Cronbach's alpha 0.79-0.64). However, the actual values of heart rate, systolic, mean, and diastolic arterial pressure were shown to decrease significantly (7-14% decrease) at 15, 30, and 60 min after a potent bolus of morphine (P < 0.001). The MAPS also demonstrated clinical feasibility. Conclusions: This study showed that 'MAPS like FLACC and VAS(obs) decreases similarly following rescue morphine. MAPS-revised can be recommended for clinical application.