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Observational Study
Validity and reliability of a pain location tool for pediatric abdominal surgery.
- James K Hamill, Alana M Cole, Andrew Liley, and Andrew G Hill.
- Department of Surgery, University of Auckland, Auckland, New Zealand; Departments of Surgery & Anaesthesia, Starship Children's Hospital, Auckland, New Zealand. Electronic address: jamesh@adhb.govt.nz.
- Pain Manag Nurs. 2015 Jun 1; 16 (3): 380-7.
AbstractFor children with surgical problems, pain location conveys important clinical information. We developed a Location and Level of Intensity of Postoperative Pain (Lolipops) tool consisting of a body outline with a seven-sector abdominal grid, the International Association for the Study of Pain Revised Faces Pain Scale, and a recording chart. The aim of the study was to assess the validity and reliability of Lolipops. Children aged 5-14 years who had undergone laparoscopic appendectomy took both nurse- and investigator-administered Lolipops, and an investigator administered Varni Thompson Pediatric Pain Questionnaires, within 24 hours of surgery. The average age of the 42 participants was 10.7 years; 64% were boys; 24 (57.1%) had acute appendicitis, 13 (31%) had perforated appendicitis, and 5 (11.9%) were uninflamed. Pain scores were higher at the laparoscopic port incision sites than in upper abdominal sites distant from incisions or expected inflammation, mean (SD) 3.3 (2.3) and 1.1 (1.8), respectively (p < .0001). In children with acute appendicitis, pain scores were higher in the right iliac fossa than in upper abdominal sites, mean (SD) 3.3 (2.5) and 0.4 (0.7), respectively (p = .001). In children with perforated appendicitis, Lolipops demonstrated a more widespread pain pattern. Correlations between nurse and investigator were fair to moderate with an overall intraclass correlation coefficient of 0.597. This study presents a new tool to measure the location of pain in pediatric surgical patients and shows it to be valid and reliable. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
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