Details

Autor(en) / Beteiligte

• Avian, Alexander
• Messerer, Brigitte
• Meissner, Winfried
• Sandner‐Kiesling, Andreas
• Kammel, Julian
• Labugger, Marlies
• Weinberg, Annelie
• Berghold, Andrea

Titel

Using a worst pain intensity measure in children and adolescents

Ist Teil von

• Journal of advanced nursing, 2017-08, Vol.73 (8), p.1873-1883

Ort / Verlag

England: Wiley Subscription Services, Inc

Erscheinungsjahr

2017

Link zum Volltext

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• Aims To explore inconsistencies and the reliability in worst pain intensity ratings in children. Background Asking for worst pain always requires a retrospective evaluation which is controversially discussed. Design Retrospective analysis of registry data and a prospective study. Methods Retrospective study: 5970 patients [age: 10·2(4·0) years, female: 41% data collection: 2008–2015]; Prospective study: 240 patients [age: 14·7(1·9) years, female: 43%, data collection 2013–2014] were included. In both studies, the number of implausible pain intensity ratings was calculated (both studies: worst pain lower than movement pain or pain at rest, prospective study: number of patients reporting lower pain intensity ratings in worst pain items for the same time period in a second assessment). Test–retest reliability was calculated for the prospective study. Changes in worst pain ratings were analyzed using Wilcoxon signed ranks test. Results Test–retest reliability ranged from ρ = 0·77–0·90. In the retrospective study, 8·9% (95%CI: 8·2–9·6%) of our patients reported higher movement and/or pain at rest compared with worst pain. In the prospective study, 35·8% (95%CI: 30·0–42·1%) reported higher activity pain ratings compared with worst pain ratings in at least one pain assessment; 13·8% of the pediatric patients reported lower pain intensity ratings in worst pain items in a second assessment compared with the first assessment. Conclusion Nine to 36% of our patients showed inconsistent worst pain ratings. To overcome this problem, more specific pain intensity items, more than one item or a better instruction for pediatric patients could be used.