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Key PointsQuestion Which are the best validated scales to assess pain and sedation among children in a preverbal stage of development?Findings This systematic review evaluated 65 scales that have been used for assessing pain or sedation in preterm infants, term infants, or toddlers.
Only 28 of 65 scales (43%) had been tested for construct validity, internal consistency, and interrater reliability.Meaning Clinicians should consider using well-validated scales when assessing pain or sedation in their target population; construct validity, internal consistency, and interrater reliability are prerequisites all such scales should provide.AbstractImportance Because children in a preverbal stage of development are unable to voice their feelings, they completely depend on their caregiving team for the interpretation and management of their pain and discomfort.
Thus, accurately validated scales to assess pain and sedation levels are crucial.Objective To provide clinicians a complete overview on the validity and reliability of the existing pain and sedation scales for different target populations (preterm infants, term infants, and toddlers) and in different clinical contexts.Evidence Review BIOSIS Previews, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, MEDLINE, PsycCRITIQUES, PsycINFO, PSYNDEXplus Literature and Audiovisual Media, and PSYNDEXplus Tests were the databases screened from their inception to August 2018.
All studies examining the validity or reliability of a given pain or sedation scale for patients in a preverbal stage of development were included in this systematic review.
Those scales that were tested for at least construct validity, internal consistency, and interrater reliability were subsequently scored using the consensus-based standards for the selection of health measurement instruments (COSMIN) checklist.Findings In total, 89 validation articles comprising 65 scales were included.
Fifty-seven scales (88%) were useful for assessing pain, 13 scales (20%) for assessing sedation, and 4 scales (6%) for assessing both conditions.
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