Three new datasets supporting use of the Numerical Rating Scale (NRS-11) for children’s self-reports of pain intensity

Abstract

Despite wide usage of the Numerical Rating Scale (NRS) for self-report of pain intensity in clinical practice with children and adolescents, validation data are lacking. We present here three datasets from studies in which the NRS was used together with another self-report scale. Study A compared post-operative pain ratings on the NRS with scores on the Faces Pain Scale-Revised (FPS-R) in 69 children age 7-17 years who had undergone a variety of surgical procedures. Study B compared post-operative pain ratings on the NRS with scores on the Visual Analogue Scale (VAS) in 29 children age 9-17 years who had undergone pectus excavatum repair. Study C compared ratings of remembered immunization pain in 236 children who comprised an NRS group and a sex- and age-matched VAS group. Correlations of the NRS with the FPS-R and VAS were r=0.87 and 0.89 in Studies A and B, respectively. In Study C, the distributions of scores on the NRS and VAS were very similar except that scores closest to the no pain anchor were more likely to be selected on the VAS than the NRS. The NRS can be considered functionally equivalent to the VAS and FPS-R except for very mild pain (<1/10). We conclude that use of the NRS is tentatively supported for clinical practice with children of 8years and older, and we recommend further research on the lower age limit and on standardized age-appropriate anchors and instructions for this scale.

Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline

“…Parents should use a global rating scale (e.g., numerical rating scale or visual analogue scale). Verbal children can be asked to self-report pain 100 using age-appropriate techniques: either the Poker Chip tool 101 (3 to 6 years of age), the Faces Pain Scale -Revised 102 (4 to 16 years of age) or a numerical rating scale 103,104 (9 years of age and older). We encourage health care providers to document the strategies used to reduce acute pain at the time of vaccine injection, as well as the child's pain score.…”

Mothers’ and fathers’ responses to their child’s pain moderate the relationship between the child’s pain catastrophizing and disability☆

“…Children rated their "most severe pain" in the past two weeks on a 100 mm VAS with the end points "no pain" and "a lot of pain". The pain severity VAS has a good reliability and validity [49].…”

First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream

“…Children from three to seven years of age reported their pain using the Wong-Baker scale (15) and children aged eight years or more, and the operators, reported pain with the Numerical Rating Scale (16). For the statistical analyses, scores from both scales were transformed into a numerical value from zero for no pain to 10 for maximum pain, in accordance with previous…”