Validation of the Italian version of the Non-Communicating Children's Pain Checklist-Postoperative Version

Italian Journal of Pediatrics, Aug 2017

This study evaluated the validity and reliability of the Italian version of the Non-Communicating Children’s Pain Checklist-Postoperative version (I-NCCPC-PV). The original NCCPC-PV version was translated into Italian following the guidelines for “the translation, adaptation, and validation of instruments or scales for cross-cultural healthcare research”. We tested the Italian NCCPC-PV version (I-NCCPC-PV) in 40 children (3–18 years of age) with severe to profound Intellectual Disability and no verbal communication. Each child’s behavior was observed by a parent or caregiver and by an external observer in a quiet situation and a painful one. They independently assessed the child’s level of pain using the translated Italian version of the NCCPCPV (I-NCCPC-PV). The results from 80 assessments showed that children’s behavioral signs differed significantly between painful and calm situations (p < 0.001). The inter-rater reliability was poor in a quiet condition (ICC 0.62) and fair in a painful situation (ICC 0.77). The inter-rater agreement was good in both calm and painful conditions (72.50% and 77.50% respectively). The Italian version of the NCCPC-PV (I-NCCPC-PV) can be used for pain assessment in children with Intellectual Disability who lack verbal communication.

A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser.

Alternatively, you can download the file locally and open with any standalone PDF reader:

https://ijponline.biomedcentral.com/track/pdf/10.1186/s13052-017-0388-2?site=ijponline.biomedcentral.com

Validation of the Italian version of the Non-Communicating Children's Pain Checklist-Postoperative Version

Zanchi et al. Italian Journal of Pediatrics Validation of the Italian version of the Non- Communicating Children's Pain Checklist- Postoperative Version C. Zanchi 3 M. Massaro 0 G. Ferrara 0 1 4 M. Montico 3 F. D'Osualdo 2 R. Rutigliano 3 A. Taddio 0 3 L. Vecchi Brumatti 3 G. Cozzi 3 E. Barbi 3 0 University of Trieste , Trieste , Italy 1 Pediatric Clinic, Insitute for Maternal and Child Health IRCCS Burlo Garofolo , via dell'Istria 65/1, Trieste , Italy 2 Institute of Physiatrics and Rehabilitation Gervasutta , Udine , Italy 3 Institute for Maternal and Child Health IRCCS “Burlo Garofolo” Trieste , Trieste , Italy 4 Pediatric Clinic, Insitute for Maternal and Child Health IRCCS Burlo Garofolo , via dell'Istria 65/1, Trieste , Italy Background: This study evaluated the validity and reliability of the Italian version of the Non-Communicating Children's Pain Checklist-Postoperative version (I-NCCPC-PV). Methods: The original NCCPC-PV version was translated into Italian following the guidelines for “the translation, adaptation, and validation of instruments or scales for cross-cultural healthcare research”. We tested the Italian NCCPC-PV version (I-NCCPC-PV) in 40 children (3-18 years of age) with severe to profound Intellectual Disability and no verbal communication. Each child's behavior was observed by a parent or caregiver and by an external observer in a quiet situation and a painful one. They independently assessed the child's level of pain using the translated Italian version of the NCCPCPV (I-NCCPC-PV). Results: The results from 80 assessments showed that children's behavioral signs differed significantly between painful and calm situations (p < 0.001). The inter-rater reliability was poor in a quiet condition (ICC 0.62) and fair in a painful situation (ICC 0.77). The inter-rater agreement was good in both calm and painful conditions (72.50% and 77.50% respectively). Conclusion: The Italian version of the NCCPC-PV (I-NCCPC-PV) can be used for pain assessment in children with Intellectual Disability who lack verbal communication. Child; Pain; Intellectual disability; Pain assessment Background Pediatric pain management is an important and challenging area of research, especially in children with Intellectual Disability (ID). Patients with ID experience pain more frequently than healthy children: they are at a high risk of chronic conditions and associated diseases which could evoke pain: muscular contractures, chronic constipation, gastro-esophageal reflux, hip-luxation, bone fractures and tooth decay. Moreover, they frequently need invasive diagnostic and therapeutic procedures which can lead to stressful and painful situations, such as botulinum toxin injection, gastrointestinal endoscopy, stomatological treatment, blood sampling and surgical procedures [ 1, 2 ]. Pain has a strong negative impact on the quality of life of these children and their families, and it interferes with their ability to perform established skills. Chronic pain has also been associated with sleep disturbances, increased fatigue, depression and decreased physical functioning [ 3–6 ]. A study that described the pattern of these children’s typical pain on a daily basis revealed that 35 to 52% of children with moderate to profound ID felt pain each week, and the average time they spent in pain was 9–10 h per week. Children with the poorest abilities resulted in experiencing the greatest pain [ 3, 7 ]. Nevertheless, their pain often remains unrecognized and untreated, due to their limited capacities to self-report pain [1]. In the last 10 years, several observational pain assessment tools were developed, mainly based on the observation of physiological and behavioral indicators of pain; unfortunately, these are not routinely used in clinical settings. We recently conducted a telephone interview contacting 56 pediatric wards in three regions of NorthEastern Italy and only 1 center out of 56 reported to use a specific tool for pain assessment in children with CI [ 8 ]. The lack of a valid and reliable Italian pain assessment tool makes it difficult for health professionals to evaluate a child’s pain and to provide effective pain treatment, and this results in poor pain management. Recent reports proved that children with ID undergoing surgery receive less opioid infusion in the perioperative period than children without ID [ 9–11 ]. The Non-Communicating Children’s Pain ChecklistPostoperative version (NCCPC-PV) is a pain assessment tool specifically designed for children between 3 and 18 years of age with ID, which has been developed from semi-structured interviews with parents of children with severe neurological impairment. It is proved to be a valid and reliable instrument to evaluate pain even when it is used by adults who are not familiar with the patients, and it is easy to perform also in a clinical setting [ 2, 7, 12, 13 ]. An Italian version of the NCCPC-PV has not been validated yet. The aim of our stud (...truncated)


This is a preview of a remote PDF: https://ijponline.biomedcentral.com/track/pdf/10.1186/s13052-017-0388-2?site=ijponline.biomedcentral.com

C. Zanchi, M. Massaro, G. Ferrara, M. Montico, F. D’Osualdo, R. Rutigliano, A. Taddio, L. Vecchi Brumatti, G. Cozzi, E. Barbi. Validation of the Italian version of the Non-Communicating Children's Pain Checklist-Postoperative Version, Italian Journal of Pediatrics, 2017, pp. 75, DOI: 10.1186/s13052-017-0388-2