Judy Peters1
1) United Kingdom
There are particular challenges inherent in eliciting a self-report of pain intensity in preschool children due to their developing cognition and communication skills which may affect the sensitivity of self-report tools used by them during painful procedures.
The aim of this study is to ascertain the validity of the Wong Baker Faces Pain Rating Scale (WBFPRS) (Wong & Baker 1988) and Poker Chip Tool (PCT) (Hester et al, 1979) in children between the ages of 3 and 4 years undergoing venepuncture.
A purposive sample of twelve children, between 3 and 4 years of age, undergoing venepuncture, gave a pain-intensity self-report using the WBFPRS and PCT before and immediately following venepuncture. Pain intensity scores were also taken before and during the procedure using the FLACC behavioural scale (Malviya et al, 1997).
The study approved by the hospital and local ethics committees. The authors declare no conflict of interest.
58% [n=7] of children using the PCT and 41% [n=5] of children using the WBFPRS failed to score ‘no pain’ prior to venepuncture.
58% [n=7] of children using the PCT and 58% [n=7] of children using the WBFPRS reported a pain intensity during venepuncture that was inconsistent with the pain intensity measured using FLACC.
Difficulties using the PCT and WBFPRS were seen across the age ranges (3yrs 1month – 4 years 8 months)
This small scale study suggests that children aged 3-4 years may struggle to accurately communicate their pain intensity using the WBFPRS and PCT.
Hester, N. (1979) The preoperational child’s reaction to immunisation. Nurse Researcher;28,4:250–5
Malviya S, Merkel SI, Shayevitz JR, Voepel-Lewis T (1997) The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatric Nursing;23,3:293
Wong, D. L. Baker, C.M. (1988) Pain in Children: Comparison of Assessment Scales. Pediatric Nursing;14,1:9-17
