Reliability and validity of the Japanese version of the Paediatric Pain Profile for children with severe motor and intellectual disabilities.

Children with severe motor and intellectual disabilities experience chronic pain but cannot communicate verbally. However, no Japanese tool currently exists for assessing pain in this population. This study aimed to develop and evaluate the reliability and validity of a Japanese version of the Paediatric Pain Profile, which is a behavioral rating scale to assess pain in children with severe neurological disabilities. The sample comprised 30 children with severe motor and intellectual disabilities at three hospitals in Japan. Three specialist nurses rated low and high pain video scenes of the children (twice at 1-week intervals) using the Face, Legs, Activity, Cry, Consolability behavioral scale and a translated Japanese version of the Paediatric Pain Profile. On the basis of their ratings, we calculated the internal consistency, test-retest reliability, and intra- and inter-observer reliabilities of the Paediatric Pain Profile. Additionally, we assessed concurrent validity using the Face, Legs, Activity, Cry, Consolability behavioral scale and construct validity using low versus high pain scenes. Both internal consistency (low pain: alpha = 0.735; high pain: alpha = 0.928) and test-retest reliability (r = 0.846) of the Japanese version of the Paediatric Pain Profile were good. Intra-observer reliability was substantial (r = 0.748), whereas inter-observer reliability was only moderate (r = 0.529). However, the concurrent validity with Face, Legs, Activity, Cry, Consolability scores was good (r = 0.629) and construct validity was confirmed (p < 0.001). We confirmed the validity of the Japanese version of the Paediatric Pain Profile, but reliable pain assessment may require repeated ratings by the same person. To accurately assess pain in children with severe motor and intellectual disabilities, healthcare staff must be properly trained and become more skilled in using the Japanese version of the Paediatric Pain Profile

痛み評価尺度Paediatric Pain Profile日本語版の開発

application/pdf本研究は、重症心身障害児など言葉で痛みを伝えられない子どもの慢性疼痛を測定する尺度「Paediatric Pain Profile日本語版」を開発し、その信頼性と妥当性を実証した。さらに、Paediatric Pain Profile日本語版を使用し、重症心身障害児の痛みの代理評価に与える要因として、その子どもをよく知る人はその子どものことを知らない人よりも痛みのスコアを高くつけたという観察者側の要因と、医療依存度の高い低年齢の子どもたちや側弯のある高年齢の子どもたち、そしてGERのある子どもたちの痛みスコアが高くなったという子ども側の要因を明らかにした。In this study, we developed a scale 'Japanese version of the Paediatric Pain Profile' to measure chronic pain in non-verbal children, such as children with severe motor and intellectual disabilities, and demonstrated its reliability and validity. In addition, the impact on the proxy assessments using this scale was that those who were always spending at the child checked higher pain scores. Observers gave high pain scores to younger children who were highly dependent on medical care, older children with scoliosis, and children with GERD.2019年度～2021年度科学研究費補助金(基盤研究(C))研究成果報告書19K1103