Postoperative pain assessment in ambulatory pediatric patients by parents

Abstract

Objectives: This study aimed to assess 1) agreement and correlation of postoperative pain scores rated by nurses and parents 2) the difference between the pain scores (CHEOPS and FLACC) as rated by nurses and parents 3) effects of parental education on pain rating 4) the ease with which parents could score CHEOPS and FLACC. Methods: Sixty-nine children, age 1-12 years (median 3.7, IQR 2-6.85 years) underwent herniorrhaphy and hydrocoelectomy under general anesthesia and 69 parents, age 20-65 years (median 32, IQR 37.5-38.5 years) were enrolled in the study. Parents were trained how to score pain using CHEOPS and FLACC by using a videotape of children's pain behaviors. One of 2 nurses who were tested for inter-rater reliability (ICC>0.9) rated the postoperative pain of a child in the recovery room at the same time with his parent by using CHEOPS and FLACC. Results: Agreement (ICC) and Correlation Coefficient (r) between nurses and parents were 0.934-0.979 and 0.898-0.969 respectively (p<0.001). ICC and r were not influenced by parental education. Pain scores rated by parents using either CHEOPS or FLACC showed no difference between the scoring systems (p=0.544, 0.166). Conclusion: Thai parents could be easily trained how to use pain scales. Parental rating was not different from nurse rating. The agreement and correlation between parents and nurses were very high. The ease of using CHEOPS was not different from FLACC.