Establishing intra- and inter-rater agreement of the Face, Legs, Activity, Cry, Consolability scale for evaluating pain in toddlers during immunization
Establishing intra- and inter-rater agreement of the Face, Legs, Activity, Cry, Consolability scale for evaluating pain in toddlers during immunization
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DOI：
10.1155/2013/897104
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发表时间：
2013-11-01
影响因子：
2.9
通讯作者：
Harrison, Denise
中科院分区：
文献类型：
--
作者：
Gomez, Rebecca J.;Barrowman, Nick;Harrison, Denise
背景：面部、腿部、活动、哭泣、安慰（FLACC）量表是一个五项工具，用于评估幼儿术后疼痛。该工具经常被用作研究幼儿急性程序性疼痛的结果测量；然而，在这方面发表的心理测量数据有限。目的：探讨幼儿免疫接种过程中FLACC量表的评分间和评分内一致性。方法：参与者包括从免疫接种服务中招募的幼儿方便样本，他们是一个更大的试点随机对照试验的一部分。在免疫接种过程中对幼儿进行录像和录音。第一评分者在三周内以随机顺序对每个视频进行两次评分（内部评分者一致），而第二评分者对每个视频进行一次评分，并且不知道第一评分者的分数（内部评分者一致）。在整个过程中，FLACC量表在四个时间点进行评分。用类内相关系数评价FLACC量表的一致性。结果：招募了30名12 - 18个月的幼儿，其中29名有视频数据。基线时的一致性系数为0.88，第一针插入时的一致性系数为0.97，末针注射后15 s和30 s的一致性系数分别为0.80和0.81。评分间系数在基线时为0.40，在第一针插入时为0.95，在最后一次注射后15 s和30 s分别为0.81和0.78。结论：FLACC量表在评估幼儿免疫接种期间的疼痛方面具有充分的一致性，特别是在接种过程中最痛苦的时期。
BACKGROUND: The Face, Legs, Activity, Cry, Consolability (FLACC) scale is a five-item tool that was developed to assess postoperative pain in young children. The tool is frequently used as an outcome measure in studies investigating acute procedural pain in young children; however, there are limited published psychometric data in this context.OBJECTIVE: To establish inter-rater and intrarater agreement of the FLACC scale in toddlers during immunization.METHODS: Participants comprised a convenience sample of toddlers recruited from an immunization drop-in service, who were part of a larger pilot randomized controlled trial. Toddlers were video-and audiotaped during immunization procedures. The first rater scored each video twice in random order over a period of three weeks (intrarater agreement), while the second rater scored each video once and was blinded to the first rater's scores (inter-rater agreement). The FLACC scale was scored at four time-points throughout the procedure. Intraclass correlation coefficients were used to assess agreement of the FLACC scale.RESULTS: Thirty toddlers between 12 and 18 months of age were recruited, and video data were available for 29. Intrarater agreement coefficients were 0.88 at baseline, 0.97 at insertion of first needle, and 0.80 and 0.81 at 15 s and 30 s following the final injection, respectively. Inter-rater coefficients were 0.40 at baseline, 0.95 at insertion of first needle, and 0.81 and 0.78 at 15 s and 30 s following the final injection, respectively.CONCLUSIONS: The FLACC scale has sufficient agreement in assessing pain in toddlers during immunizations, especially during the most painful periods of the procedure.