Where Are We: A Systematic Evaluation of the Psychometric Properties of Pain Assessment Scales for Use in Chinese Children.

Systematic pain assessment using reliable and valid pain scales is the foundation for optimal pain management in children. To evaluate the available scales for pain assessment in Chinese children, we systematically evaluated the psychometric properties of pain measurements used in Chinese children. We searched Chinese- and English-language databases from their inception to September 2013. Studies were eligible for inclusion if the psychometric properties of pain measures were examined in Chinese children (aged 0-18 years). Two bilingual reviewers independently evaluated the psychometric properties of the identified pain scales by a revised 11-item coding system. In all, 6 studies involving 775 participants were included in this review with six pain scales examined, including the Face, Legs, Activity, Cry, and Consolability (FLACC) Scale, COMFORT-Behavior Scale, Asian Version of Oucher Scale, Pain Observation Scale for Young Children (POCIS), Neonatal Facial Coding System (NFCS) and Pain Assessment Scale for Preterm Infants (PASPI). The FLACC, COMFORT-Behavior Scale, and PASPI had very good psychometric qualities when administered in Chinese children; the Asian Version of Oucher Scale and POCIS showed acceptable to good psychometric qualities; and the NFCS had unacceptable psychometric qualities. Further psychometric testing of these observational measures and self-report pain scales in particular are needed among Chinese children of various age groups and in different pain situations.