Health care professionals who work with children have an especially difficult task when it comes to assessment of pain, particularly acute pain. Proper assessment of pediatric pain symptoms is needed not only for managing symptoms, but also for determining effective treatment and intervention. There are several assessment tools available for pediatric pain, the most common being either Likert scales (rate pain on scale of 1 to 10) or a series of cartoon type faces showing various amounts of distress. None of the current assessment techniques have been adapted for presentation/scoring/tracking via computer. Moreover, none of the assessment techniques utilize any physiological response indicators of pain in conjunction with self-report. The goal of this project is to develop a computerized face scale assessment - the Show-n-Tell - that will reliably quantify degree of pain symptoms in children and gather physiological measurement (heart rate and blood pressure) concurrent with self-report. Versions specific for gender, age, and ethnicity will be developed. The faces will be presented on a hand-held PC with touch screen capability. The child will see an initial neutral face which they can adjust through various levels of pain to indicate their level of perceived pain. Concurrently, unobtrusive physiological monitors worn by the child will register heart rate and blood pressure. In the Phase I portion, we will: 1) demonstrate that pediatric patients can reliably use a face scale on a handheld device to translate their pain level, 2) assess the association between self-report and physiological indications of pain, 3) assess the correlation between the child's self- report, physician rating, and parent rating in a sample of children with acute pain, 4) assess the feasibility of using the Show-n-Tell in a Physical Therapy Clinic and other specialized assessment settings.
This study will provide a quick and easy assessment of pain in children that can be presented and tracked on a hand held computer with concurrent physiological assessment. This test will allow patients, researchers, clinicians and policy-makers to collaborate in addressing the complex illness management issues faced by the numerous health care providers who assess pediatric pain. Specialized pain interventions have the potential to decrease morbidity, healthcare costs, and better track patient related outcomes.
