Faces Pain Scale - Revised: Difference between revisions

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== 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 analog 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. It was modified 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 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 pain 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>. It is relatively simple to administer.


== Intended Population ==
== Intended Population ==
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== Method of Use  ==
== Method of Use  ==
According to the [https://www.iasp-pain.org/ International Association For The Study Of Pain] (IASP), it is a self-reported measure of pain intensity, that requires little equipment like the photocopied faces. The absence of smiles and tears on this scale is advantageous. It is particularly recommended for use with children older than 4. 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.
According to the [https://www.iasp-pain.org/ International Association For The Study Of Pain] (IASP), it is a self-reported measure of pain intensity, that requires very few instruments like the photocopied faces to administer. The lack of smiles and tears on the scale is advantageous. It is particularly recommended for use with children older than 4. 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.


== 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]] 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 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 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.
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 [https://www.iasp-pain.org/resources/faces-pain-scale-revised/ here] for free.
You can download the tool [https://www.iasp-pain.org/resources/faces-pain-scale-revised/ here] for free.

Revision as of 19:36, 23 April 2022

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. It was modified from the Faces Pain Scale[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 pain scale (VAS) throughout the 4 to 16 years age group[3]. It is relatively simple to administer.

Intended Population[edit | edit source]

Children older than 4 years old

Method of Use[edit | edit source]

According to the International Association For The Study Of Pain (IASP), it is a self-reported measure of pain intensity, that requires very few instruments like the photocopied faces to administer. The lack of smiles and tears on the scale is advantageous. It is particularly recommended for use with children older than 4. 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.

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).[4]

Validity[edit | edit source]

In the same study that assessed pre and post analgesia administration pain scores, FPS-R was compared against the VAS and Pearson correlations between the two were found to be r = 0.78 at 60 minutes after medication administration, showing positive and strong correlations[4].

Responsiveness[edit | edit source]

The scale demonstrated good responsiveness to change in the study[4] 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. 4.0 4.1 4.2 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