Show-N-Tell: Computerized Assessment of Pain in Children

描述（由申请人提供）：与儿童一起工作的卫生保健专业人员在评估疼痛，特别是急性疼痛时，有一项特别困难的任务。对儿童疼痛症状进行适当评估不仅是为了控制症状，也是为了确定有效的治疗和干预措施。有几种评估儿童疼痛的工具，最常见的是李克特量表（1到10的疼痛等级）或一系列卡通类型的脸，显示不同程度的痛苦。目前没有一种评估技术被用于通过计算机进行演示/评分/跟踪。此外，没有一种评估技术将疼痛的生理反应指标与自我报告相结合。该项目的目标是开发一种计算机化的面部量表评估——显示-n-告诉——它将可靠地量化儿童疼痛症状的程度，并收集与自我报告同时进行的生理测量（心率和血压）。将开发针对性别、年龄和种族的版本。这些人脸将被显示在一台具有触摸屏功能的手持电脑上。孩子一开始会看到一张中性的脸他们可以通过不同程度的疼痛来调整这张脸来表明他们感知到的疼痛程度。同时，孩子佩戴的不显眼的生理监测器将记录心率和血压。在第一阶段，我们将：1)证明儿科患者可以可靠地使用手持设备上的面部量表来翻译他们的疼痛水平，2)评估自我报告与疼痛的生理适应症之间的关联，3)评估急性疼痛儿童样本中儿童自我报告，医生评分和家长评分之间的相关性，4)评估在物理治疗诊所和其他专业评估设置中使用显示-n-告诉的可行性。公共卫生相关性：本研究将提供一种快速简便的儿童疼痛评估方法，该方法可以在手持计算机上呈现和跟踪，同时进行生理评估。这个测试将允许患者，研究人员，临床医生和政策制定者合作，解决复杂的疾病管理问题所面临的众多卫生保健提供者谁评估儿科疼痛。专门的疼痛干预有可能降低发病率、医疗成本，并更好地跟踪患者相关的结果。

DESCRIPTION (provided by applicant): Health care professionals who work with children have an especially difficult task when it comes to assessment of pain, particularly acute pain. Proper assessment of pediatric pain symptoms is needed not only for managing symptoms, but also for determining effective treatment and intervention. There are several assessment tools available for pediatric pain, the most common being either Likert scales (rate pain on scale of 1 to 10) or a series of cartoon type faces showing various amounts of distress. None of the current assessment techniques have been adapted for presentation/scoring/tracking via computer. Moreover, none of the assessment techniques utilize any physiological response indicators of pain in conjunction with self-report. The goal of this project is to develop a computerized face scale assessment - the Show-n-Tell - that will reliably quantify degree of pain symptoms in children and gather physiological measurement (heart rate and blood pressure) concurrent with self-report. Versions specific for gender, age, and ethnicity will be developed. The faces will be presented on a hand-held PC with touch screen capability. The child will see an initial neutral face which they can adjust through various levels of pain to indicate their level of perceived pain. Concurrently, unobtrusive physiological monitors worn by the child will register heart rate and blood pressure. In the Phase I portion, we will: 1) demonstrate that pediatric patients can reliably use a face scale on a handheld device to translate their pain level, 2) assess the association between self-report and physiological indications of pain, 3) assess the correlation between the child's self- report, physician rating, and parent rating in a sample of children with acute pain, 4) assess the feasibility of using the Show-n-Tell in a Physical Therapy Clinic and other specialized assessment settings. PUBLIC HEALTH RELEVANCE: This study will provide a quick and easy assessment of pain in children that can be presented and tracked on a hand held computer with concurrent physiological assessment. This test will allow patients, researchers, clinicians and policy-makers to collaborate in addressing the complex illness management issues faced by the numerous health care providers who assess pediatric pain. Specialized pain interventions have the potential to decrease morbidity, healthcare costs, and better track patient related outcomes.