Dianne Crellin1, Franz E Babl1, Nick Santamaria1, Denise Harrison2
1) Australia 2) Canada
Background and aim: The Modified Behavioral Pain Scale (MBPS) is generally accepted as a valid measure of infant immunisation pain. However, the validity of the scale has not been adequately summarised to provide clear recommendations regarding its use. We set out to systematically review the scale’s reliability, validity, feasibility and clinical utility and provide contemporary recommendations regarding its use.
Methods: A systematic search of the literature to identify studies reporting feasibility, reliability, validity or utility data for the MBPS applied to children (aged birth to 18 years) and randomised controlled trials (RCT) using the MBPS scale to measure a study outcome was conducted. The search terms 'MBPS' and 'Modified Behavioral Pain Scale' were used to search the following databases; MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and Cochrane Controlled Trials, Cumulative Index Nursing and Allied Health Literature (CINAHL) and PsycINFO from 1990 to 31st July 2016. Data analysis involved; quality assessment of the studies and narrative synthesis of results as data could not be combined for meta-analysis.
Results: Twenty-nine studies (9 psychometric and 20 RCTs) of varying quality were included. Sufficient data is available to cautiously accept the MBPS as valid for assessing immunisation related pain in infants aged 2 to 22 months. There is insufficient data to support the psychometrics in other age groups or in circumstances other than immunisation. There is limited data addressing the feasibility or clinical utility of the MBPS.
Conclusions: The MBPS can be recommended to assess immunisation pain in infants. Data is needed to confirm the validity of the scale for alternative procedures and wider age ranges and the clinical utility of the scale before the scale can be recommended for alternative age groups or procedures. Furthermore, the capacity of the scale to distinguish between pain and non-pain related distress is largely unknown.
