Validation Of One-Dimensional With Two-Dimensional Pain Scales In Post-Operative Children: Randomised Control Trial At A Single Based Hospital In Jordan

Abstract

Manal Kassab, Mohammad Rababa, Shereen hamandneh, Khawla Nuseir, Marwa Othman, Anit N Roy

Context: Acute procedural pain is a very prevalent problem among post-operative children. However, it is still under-assessed and under-treated due to pain assessment complexity of and delayed treatment of pain in post-operative children. Assessing post-operative pain using valid tools to guide child pain management decisions. Despite multiple research studies of postoperative pain in children, it remains unclear whether using one-dimensional alone or multi-dimensional tools contributes to effective assessment and prompt adequate treatment pain in children.
Objectives: This study examined whether there is any difference in time of pain interventions administration between post-operative children assessed with face pain scale alone and those assessed with face pain scale and physiological parameters.
Methods: The sample population consisted of 150 children randomly assigned into study groups (control=75, Intervention=75) using an excel table of sequential randomization. Participants in the control group assessed for post-operative pain using a one-dimensional tool (WBFPS). Participants in the intervention group were assessed using a multi-dimensional scale that included the face pain scale and physiological measurements (HR, RR, O2 Sat, and B/P). The study was conducted at surgical floors, and Paediatric Intensive Care Unit (PICU) in a single-site case setting (King Abdullah University Hospital)
Results: Data from a total of 150 participants were analysed. There was a statistically significant difference in the mean pain score level between the two groups. The mean pain score in the control group was 1.45±1.09 and in the experimental group was 2.96±1.95. The mean time of pain intervention administration in minutes in the experimental group was 30.89 ±23.1, while the mean of the administration time in the control group was 44.69 ±19.5. The mean pain score difference between groups was found to be statistically significant (p= 0.00). The 24.5% of changes in the dependent variables are affected by independent variables. The multi regression used showed a significant impact of the type of assessment tools (p=0.004), type of surgery (0.054), and intraoperative opioids (p=0.000) concerning the duration of pain intervention administration.
Conclusion: The study results show significant positive differences in pain level according to assessment tool type. The use of multi-dimensional instruments that included physiological measurements was more accurate. It led to more effective pain management than one-dimensional instruments that only had face pain scale.