No Single Standard for Faces Pain Scales for Children

Leading pain scales all found to have validity and reliability; choice depends on other factors
By Jeff Muise
HealthDay Reporter

MONDAY, Oct. 4 (HealthDay News) -- There is no single faces pain scale for use in children that is superior to the others in all respects, according to an article published online Oct. 4 in Pediatrics.

Deborah Tomlinson, R.N., of the Hospital for Sick Children in Toronto, and colleagues searched the medical literature for studies using faces pain scales for children's self-assessment of pain. The reviewers identified 14 faces pain scales, focusing on four with the most psychometric testing: Faces Pain Scale (FPS), Faces Pain Scale-Revised (FPS-R), Oucher pain scale, and Wong-Baker Faces Pain Rating Scale (WBFPRS).

The reviewers found that the FPS-R scale was supported by the most extensive data for reliability and validity, though the WBFPRS and Oucher scales were adequately supported as well. The WBFPRS was preferred by children, but the inclusion of smiling and crying faces among the WBFPRS face choices raised the possibility of children confusing emotion with pain. The FPS-R was judged better for making psychometric measurements, which might make it preferable for researchers.

"For clinical use, we found no grounds to switch from one faces scale to another when one of the scales is in use. For research use, the FPS-R has been recommended on the basis of utility and psychometric features," the authors write.

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