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Pain assessment tools in paediatric palliative care: a systematic review of psychometric properties and recommendations for clinical practice

Pain assessment tools in paediatric palliative care: a systematic review of psychometric properties and recommendations for clinical practice
Pain assessment tools in paediatric palliative care: a systematic review of psychometric properties and recommendations for clinical practice

Background: assessing pain in infants, children and young people with life-limiting conditions remains a challenge due to diverse patient conditions, types of pain and often a reduced ability or inability of patients to communicate verbally.

Aim: to systematically identify pain assessment tools that are currently used in paediatric palliative care and examine their psychometric properties and feasibility and make recommendations for clinical practice.

Design: a systematic literature review and evaluation of psychometric properties of pain assessment tools of original peer-reviewed research published from inception of data sources to April 2021.

Data sources: PsycINFO via ProQuest, Web of Science Core, Medline via Ovid, EMBASE, BIOSIS and CINAHL were searched from inception to April 2021. Hand searches of reference lists of included studies and relevant reviews were performed.

Results: from 1168 articles identified, 201 papers were selected for full-text assessment. Thirty-four articles met the eligibility criteria and we examined the psychometric properties of 22 pain assessment tools. Overall, the Faces Pain Scale-Revised (FPS-R) had high cross-cultural validity, construct validity (hypothesis testing) and responsiveness; while the Faces, Legs, Activity, Cry and Consolability (FLACC) scale and Paediatric Pain Profile (PPP) had high internal consistency, criterion validity, reliability and responsiveness. The number of studies per psychometric property of each pain assessment tool was limited and the methodological quality of included studies was low.

Conclusion: balancing aspects of feasibility and psychometric properties, the FPS-R is recommended for self-assessment, and the FLACC scale/FLACC Revised and PPP are the recommended observational tools in their respective age groups.

Pain measurement, paediatrics, pain assessment, palliative care
0269-2163
30-43
Chan, Adrienne Y.L.
2428c166-6e13-4632-9080-612172b37fe5
Ge, Mengqin
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Harrop, Emily
01114a0a-f1c8-4d71-aaff-c50365561ddd
Johnson, Margaret
722ce22b-1571-4753-bec0-9829e8ce7e92
Oulton, Kate
6725a8ee-03cc-4349-8320-94103bc5850e
Skene, Simon S
c9fbaf39-be87-4207-a6d6-5bf5477e675c
Wong, Ian C.K.
cf41b85b-9cb1-4213-9a97-62e7bbe9b154
Jamieson, Liz
b57748f6-7e0a-4d3b-b292-fc00c27ee661
Howard, Richard F.
4ba52e52-9d22-4769-9e3e-e99a8acd012d
Liossi, Christina
fd401ad6-581a-4a31-a60b-f8671ffd3558
Chan, Adrienne Y.L.
2428c166-6e13-4632-9080-612172b37fe5
Ge, Mengqin
02c7c77d-6c2c-411a-9b0a-fcbd1cb9e657
Harrop, Emily
01114a0a-f1c8-4d71-aaff-c50365561ddd
Johnson, Margaret
722ce22b-1571-4753-bec0-9829e8ce7e92
Oulton, Kate
6725a8ee-03cc-4349-8320-94103bc5850e
Skene, Simon S
c9fbaf39-be87-4207-a6d6-5bf5477e675c
Wong, Ian C.K.
cf41b85b-9cb1-4213-9a97-62e7bbe9b154
Jamieson, Liz
b57748f6-7e0a-4d3b-b292-fc00c27ee661
Howard, Richard F.
4ba52e52-9d22-4769-9e3e-e99a8acd012d
Liossi, Christina
fd401ad6-581a-4a31-a60b-f8671ffd3558

Chan, Adrienne Y.L., Ge, Mengqin, Harrop, Emily, Johnson, Margaret, Oulton, Kate, Skene, Simon S, Wong, Ian C.K., Jamieson, Liz, Howard, Richard F. and Liossi, Christina (2022) Pain assessment tools in paediatric palliative care: a systematic review of psychometric properties and recommendations for clinical practice. Palliative Medicine, 36 (1), 30-43. (doi:10.1177/02692163211049309).

Record type: Article

Abstract

Background: assessing pain in infants, children and young people with life-limiting conditions remains a challenge due to diverse patient conditions, types of pain and often a reduced ability or inability of patients to communicate verbally.

Aim: to systematically identify pain assessment tools that are currently used in paediatric palliative care and examine their psychometric properties and feasibility and make recommendations for clinical practice.

Design: a systematic literature review and evaluation of psychometric properties of pain assessment tools of original peer-reviewed research published from inception of data sources to April 2021.

Data sources: PsycINFO via ProQuest, Web of Science Core, Medline via Ovid, EMBASE, BIOSIS and CINAHL were searched from inception to April 2021. Hand searches of reference lists of included studies and relevant reviews were performed.

Results: from 1168 articles identified, 201 papers were selected for full-text assessment. Thirty-four articles met the eligibility criteria and we examined the psychometric properties of 22 pain assessment tools. Overall, the Faces Pain Scale-Revised (FPS-R) had high cross-cultural validity, construct validity (hypothesis testing) and responsiveness; while the Faces, Legs, Activity, Cry and Consolability (FLACC) scale and Paediatric Pain Profile (PPP) had high internal consistency, criterion validity, reliability and responsiveness. The number of studies per psychometric property of each pain assessment tool was limited and the methodological quality of included studies was low.

Conclusion: balancing aspects of feasibility and psychometric properties, the FPS-R is recommended for self-assessment, and the FLACC scale/FLACC Revised and PPP are the recommended observational tools in their respective age groups.

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More information

e-pub ahead of print date: 29 December 2021
Published date: 1 January 2022
Additional Information: Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project is funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0317-20036). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Keywords: Pain measurement, paediatrics, pain assessment, palliative care

Identifiers

Local EPrints ID: 455147
URI: http://eprints.soton.ac.uk/id/eprint/455147
ISSN: 0269-2163
PURE UUID: ab20dc27-1269-4494-9ee3-3d90ca9fc619
ORCID for Christina Liossi: ORCID iD orcid.org/0000-0003-0627-6377

Catalogue record

Date deposited: 10 Mar 2022 19:01
Last modified: 01 Jul 2022 01:42

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Contributors

Author: Adrienne Y.L. Chan
Author: Mengqin Ge
Author: Emily Harrop
Author: Margaret Johnson
Author: Kate Oulton
Author: Simon S Skene
Author: Ian C.K. Wong
Author: Liz Jamieson
Author: Richard F. Howard

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