Validation of the Numerical Rating Scale for Pain Intensity and Unpleasantness in Pediatric Acute Postoperative Pain: Sensitivity to Change Over Time

Abstract

This study evaluates the construct validity (including sensitivity to change) of the numerical rating scale (NRS) for pain intensity (I) and unpleasantness (U) and participant pain scale preferences in children/adolescents with acute postoperative pain. Eighty-three children aged 8 to 18 years (mean = 13.8, SD = 2.4) completed 3 pain scales including NRS, Verbal Rating Scale (VRS), and faces scales (Faces Pain Scale-Revised [FPS-R] and Facial Affective Scale [FAS], respectively) for pain intensity (I) and unpleasantness (U) 48 to 72 hours after major surgery, and the NRS, VRS and Functional Disability Index (FDI) 2 weeks after surgery. As predicted, the NRSI correlated highly with the VRSI and FPS-R and the NRSU correlated highly with the VRSU and FAS 48 to 72 hours after surgery. The FDI correlated moderately with the NRS at both time points. Scores on the NRSI and NRSU at 48 to 72 hours were significantly higher than at 2 weeks after surgery. Children found the faces scales the easiest to use while the VRS was liked the least and was the hardest to use. The NRS has adequate evidence of construct validity including sensitivity for both pain intensity and unpleasantness. This study further supports the validity of the NRS as a tool to measure both intensity and unpleasantness of acute pain in children.Perspective: This article evaluates the construct validity including sensitivity of the Numerical Rating Scale for pain intensity and pain unpleasantness over time in children after major surgery. The NRS could be used by clinicians to assess these 2 different dimensions of children's pain experience in acute pain settings.

Remembering pain after surgery

“…Pain intensity was rated at the end of the day (in the evening) using an 11-point numerical rating scale (NRS) (anchors: 0 = no pain, 10 = worst pain). Numerical ratings scales are a valid and reliable tool to assess pain intensity and are recommended for assessment of pain intensity for acute pediatric postsurgical pain in youth [28]. Prospectively captured pain scores minimize recall biases.…”

Utilizing Z-track Air Lock Technique to Reduce Pain in Intramuscular Injections

“…Kategori 0: tidak nyeri (menyatakan tidak nyeri), 1 adalah nyeri ringan (menyatakan nyeri tanpa perubahan perilaku nyeri), 2 adalah nyeri sedang (menyatakan nyeri tanpa ditanya dan dibarengi perubahan perilaku seperti wajah tegang), 3 adalah nyeri berat (menyatakan nyeri dengan keras wajah meringis, berteriak, mengeluarkan air mata, tangan tidak mau dipegang). VRS adalah intstrumen yang sudah valid (p =.01) dan lazim digunakan dalam praktek klinis untuk mengukur intensitas nyeri (Page, et al, 2012).…”

Perioperative effects of caudal and transversus abdominis plane (TAP) blocks for children undergoing urologic robot-assisted laparoscopic surgery

“…however, there is moderate concurrence between the FLACC and Faces pain scales [28] and strong concurrence between the Faces and verbal numeric scales [29]. As shown in the Supplementary Data, there were no significant differences between the treatment groups of the present cohort in the percentage of patients for whom each type of pain scale was used or in pain scores stratified by scale.…”