Faces Pain Scale - Revised: Difference between revisions

mNo edit summary
m (Added a category)
 
(10 intermediate revisions by 3 users not shown)
Line 5: Line 5:
</div>  
</div>  
== Objective ==
== Objective ==
Assessment of [[Pain Assessment|pain]] in children is particularly complex considering both subjectivity of the pain experience and the limits and variability of children's cognitive and social development<ref>Emmott AS, West N, Zhou G, Dunsmuir D, Montgomery CJ, Lauder GR, von Baeyer CL. [https://pubmed.ncbi.nlm.nih.gov/28069521/ Validity of Simplified Versus Standard Self-Report Measures of Pain Intensity in Preschool-Aged Children Undergoing Venipuncture]. J Pain. May 2017;18(5):564-573.</ref>. The Faces Pain Scale Revised (FPS-R) is a measure of pain intensity. It was adapted from the Faces Pain Scale<ref>Garra G, Singer A, Taira B, Chohan J. [https://onlinelibrary.wiley.com/doi/full/10.1111/j.1553-2712.2009.00620.x?casa_token=jlYIbH23QZUAAAAA%3At1KcIs7uS4tM9A9cZpMFz0HjZDyo-ZmDwhpsD2cENsL3zsnoFI3_dJzv9wpj8OHN6m8GwOnPKYpV69uh Validation of the Wong-Baker FACES Pain Rating Scale in Pediatric Emergency Department Patients.] Academic Emergency Medicine. 2010 Jan; 17 (1): 50-54</ref> to make it possible to score the sensation of pain on the widely accepted 0-to-10 metric. The scale shows a close linear relationship with [[Visual Analogue Scale|visual analogue pain scale]]<nowiki/>s (VAS) across the age range of 4-16 years<ref>Tsze DS, Hirschfeld G, Dayan PS, Bulloch B, von Baeyer CL. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123984/ Defining No Pain, Mild, Moderate, and Severe Pain Based on the Faces Pain Scale-Revised and Color Analog Scale in Children With Acute Pain]. Pediatric Emergency Care. Aug 2018;34(8):537-544.</ref>. It is easy to administer.
[[Pain Assessment|Pain examination]] in pediatric clients is not easy to analyze or understand just like in adults, due to varying pain experiences and limits, and also due to diverse social and cognitive developmental milestones<ref>Emmott AS, West N, Zhou G, Dunsmuir D, Montgomery CJ, Lauder GR, von Baeyer CL. [https://pubmed.ncbi.nlm.nih.gov/28069521/ Validity of Simplified Versus Standard Self-Report Measures of Pain Intensity in Preschool-Aged Children Undergoing Venipuncture]. J Pain. May 2017;18(5):564-573.</ref>. The Faces Pain Scale-Revised (FPS-R) is a measure of pain intensity that was modified from the [[Faces Pain Scale]] (Wong-Beker)<ref>Garra G, Singer A, Taira B, Chohan J. [https://onlinelibrary.wiley.com/doi/full/10.1111/j.1553-2712.2009.00620.x?casa_token=jlYIbH23QZUAAAAA%3At1KcIs7uS4tM9A9cZpMFz0HjZDyo-ZmDwhpsD2cENsL3zsnoFI3_dJzv9wpj8OHN6m8GwOnPKYpV69uh Validation of the Wong-Baker FACES Pain Rating Scale in Pediatric Emergency Department Patients.] Academic Emergency Medicine. 2010 Jan; 17 (1): 50-54</ref> to facilitate a more acceptable 0 to 10 criterion in scoring pain sensation. The scale shares an intimate straightforward relationship with the [[Visual Analogue Scale|visual analog scale (VAS)]] throughout the 4 to 16 years age group<ref>Tsze DS, Hirschfeld G, Dayan PS, Bulloch B, von Baeyer CL. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123984/ Defining No Pain, Mild, Moderate, and Severe Pain Based on the Faces Pain Scale-Revised and Color Analog Scale in Children With Acute Pain]. Pediatric Emergency Care. Aug 2018;34(8):537-544.</ref> and is relatively simple to administer. Unlike its predecessor, the FPS-R's lack of smiles and tears is an advantage as the grimacing faces represent a more accurate expression of pain.


== Intended Population ==
== Intended Population ==
Children older than 4 years old
School-aged/Children older than 4 years old


== Method of Use  ==
== Method of Use  ==
It is a self-reported measure of pain intensity, that requires few equipment like the photocopied faces. The absence of smiles and tears in this scale is advantageous. It is particularly recommended for use with very young children. The clinician scores the chosen face 0, 2, 4, 6, 8, or 10, counting left to right, so "0" equals "No pain" and "10" equals "Very much pain." Make sure you do not use words like "happy" and '"sad." This scale is intended to measure how children feel inside, not how their face looks.
[[File:Wong-Baker scale with emoji.png|thumb|Wong-Baker scale with emoji]]
According to the [https://www.iasp-pain.org/ International Association For The Study Of Pain] (IASP)<ref>International Association For the Study of Pain. Faces Pain scale - revised. Available from https://www.iasp-pain.org/resources/faces-pain-scale-revised/  (accessed 21 Apr 2022)</ref>, FPS-R is a self-reported measure of pain intensity, that requires little time and very few instruments like the photocopied faces to administer. The clinician scores the chosen face 0, 2, 4, 6, 8, or 10, counting left to right from the six series of faces. Take care not to use words like "happy" and '"sad" as the scale is intended to measure how children feel inside, rather than how their face looks. Below is the interpretation of the scores :
 
0 =No Pain
 
2 = Mild
 
4 =  Nagging
 
6 =Miserable
 
8 =Intense
 
10 = Worst
 


== Evidence  ==
== Evidence  ==


=== Reliability  ===
=== Reliability  ===
The indices of relative reliability showed a good agreement between the test and retest for the scale, 0.76 (95% CI 0.72-0.80).<ref name=":0" />
In a study that assessed pre and post analgesia administration pain scores the indices of relative reliability showed a good agreement between the test and retest for the scale, 0.76 (95% CI 0.72-0.80).<ref name=":0" />


=== Validity  ===
=== Validity  ===
Pearson correlations between the [[Visual Analogue Scale|Visual Analogue Scale (VAS)]] and FPS-R were found to be VAS/FPS-R: ''r'' = 0.78 at 60 minutes after medication administration, showing positive and strong correlations<ref name=":0" />.
In the same study that assessed pre and post analgesia administration pain scores, FPS-R was compared against the [[Visual Analogue Scale|VAS]] for construct validity and Pearson correlations between the two were found to be r = 0.78 at 60 minutes after medication administration, showing positive and strong correlations<ref name=":0" />.


=== Responsiveness  ===
=== Responsiveness  ===
The scale demonstrated a good responsiveness to change in a study<ref name=":0">Le May S, Ballard A, Khadra C, Gouin S; Plint, A; Villeneuve, E. [https://journals.lww.com/pain/Fulltext/2018/08000/Comparison_of_the_psychometric_properties_of_3.10.aspxA Comparison of the psychometric properties of 3 pain scales used in the pediatric emergency department: Visual Analogue Scale, Faces Pain Scale-Revised, and Colour Analogue Scale]. PAIN. 2018 Aug; 159(8): 1508-1517</ref> that assessed pain score pre and post analgesia administration. The mean pain scores pre-analgesia were SD = 1.82; median: 6.0; IQR: 4.0-6.0 and  after analgesic administration the mean pain scores were SD = 2.31; median: 4.0; IQR: 2.0-6.0. The mean differences in pain scores were significantly lower 60 minutes after the administration of the medication (mean = −1.61, SD = 2.00, ''P'' < 0.0001) which suggests a high responsiveness of the scale to pain relief.
The scale demonstrated good responsiveness to change in the study<ref name=":0">Le May S, Ballard A, Khadra C, Gouin S; Plint, A; Villeneuve, E. [https://journals.lww.com/pain/Fulltext/2018/08000/Comparison_of_the_psychometric_properties_of_3.10.aspxA Comparison of the psychometric properties of 3 pain scales used in the pediatric emergency department: Visual Analogue Scale, Faces Pain Scale-Revised, and Colour Analogue Scale]. PAIN. 2018 Aug; 159(8): 1508-1517</ref> that assessed pre and post analgesia administration pain scores. The mean pain scores pre-analgesia were SD = 1.82; median: 6.0; IQR: 4.0-6.0 and  after analgesic administration the mean pain scores were SD = 2.31; median: 4.0; IQR: 2.0-6.0. The mean differences in pain scores were significantly lower 60 minutes after the administration of the medication (mean = −1.61, SD = 2.00, ''P'' < 0.0001) which suggests high responsiveness of the scale to pain relief.
== Links  ==
== Links  ==
You can download the tool here for free, [https://www.iasp-pain.org/resources/faces-pain-scale-revised/ International Association For The Study Of Pain]
You can download the tool [https://www.iasp-pain.org/resources/faces-pain-scale-revised/ here] for free.


== References  ==
== References  ==
Line 35: Line 49:
[[Category:Outcome Measures]]
[[Category:Outcome Measures]]
[[Category:Paediatrics - Assessment and Examination]]
[[Category:Paediatrics - Assessment and Examination]]
[[Category:Paediatrics]]
[[Category:Pain - Outcome Measures]]

Latest revision as of 10:49, 26 July 2023

Objective[edit | edit source]

Pain examination in pediatric clients is not easy to analyze or understand just like in adults, due to varying pain experiences and limits, and also due to diverse social and cognitive developmental milestones[1]. The Faces Pain Scale-Revised (FPS-R) is a measure of pain intensity that was modified from the Faces Pain Scale (Wong-Beker)[2] to facilitate a more acceptable 0 to 10 criterion in scoring pain sensation. The scale shares an intimate straightforward relationship with the visual analog scale (VAS) throughout the 4 to 16 years age group[3] and is relatively simple to administer. Unlike its predecessor, the FPS-R's lack of smiles and tears is an advantage as the grimacing faces represent a more accurate expression of pain.

Intended Population[edit | edit source]

School-aged/Children older than 4 years old

Method of Use[edit | edit source]

Wong-Baker scale with emoji

According to the International Association For The Study Of Pain (IASP)[4], FPS-R is a self-reported measure of pain intensity, that requires little time and very few instruments like the photocopied faces to administer. The clinician scores the chosen face 0, 2, 4, 6, 8, or 10, counting left to right from the six series of faces. Take care not to use words like "happy" and '"sad" as the scale is intended to measure how children feel inside, rather than how their face looks. Below is the interpretation of the scores :

0 =No Pain

2 = Mild

4 = Nagging

6 =Miserable

8 =Intense

10 = Worst


Evidence[edit | edit source]

Reliability[edit | edit source]

In a study that assessed pre and post analgesia administration pain scores the indices of relative reliability showed a good agreement between the test and retest for the scale, 0.76 (95% CI 0.72-0.80).[5]

Validity[edit | edit source]

In the same study that assessed pre and post analgesia administration pain scores, FPS-R was compared against the VAS for construct validity and Pearson correlations between the two were found to be r = 0.78 at 60 minutes after medication administration, showing positive and strong correlations[5].

Responsiveness[edit | edit source]

The scale demonstrated good responsiveness to change in the study[5] that assessed pre and post analgesia administration pain scores. The mean pain scores pre-analgesia were SD = 1.82; median: 6.0; IQR: 4.0-6.0 and after analgesic administration the mean pain scores were SD = 2.31; median: 4.0; IQR: 2.0-6.0. The mean differences in pain scores were significantly lower 60 minutes after the administration of the medication (mean = −1.61, SD = 2.00, P < 0.0001) which suggests high responsiveness of the scale to pain relief.

Links[edit | edit source]

You can download the tool here for free.

References[edit | edit source]

  1. Emmott AS, West N, Zhou G, Dunsmuir D, Montgomery CJ, Lauder GR, von Baeyer CL. Validity of Simplified Versus Standard Self-Report Measures of Pain Intensity in Preschool-Aged Children Undergoing Venipuncture. J Pain. May 2017;18(5):564-573.
  2. Garra G, Singer A, Taira B, Chohan J. Validation of the Wong-Baker FACES Pain Rating Scale in Pediatric Emergency Department Patients. Academic Emergency Medicine. 2010 Jan; 17 (1): 50-54
  3. Tsze DS, Hirschfeld G, Dayan PS, Bulloch B, von Baeyer CL. Defining No Pain, Mild, Moderate, and Severe Pain Based on the Faces Pain Scale-Revised and Color Analog Scale in Children With Acute Pain. Pediatric Emergency Care. Aug 2018;34(8):537-544.
  4. International Association For the Study of Pain. Faces Pain scale - revised. Available from https://www.iasp-pain.org/resources/faces-pain-scale-revised/ (accessed 21 Apr 2022)
  5. 5.0 5.1 5.2 Le May S, Ballard A, Khadra C, Gouin S; Plint, A; Villeneuve, E. Comparison of the psychometric properties of 3 pain scales used in the pediatric emergency department: Visual Analogue Scale, Faces Pain Scale-Revised, and Colour Analogue Scale. PAIN. 2018 Aug; 159(8): 1508-1517