不同观察性疼痛量表用于口腔治疗儿童全身麻醉恢复期疼痛评估的评价  

Evaluation of different observational pain scales for pain assessment during the general anesthesia recovery period in children undergoing dental treatment

作　　者：黄秀霞 李漓[1] 刘河娣 周美容 岑金燕 Huang Xiuxia;Li Li;Liu Hedi;Zhou Meirong;Cen Jinyan(Clinical Nursing Education and Research Section,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China;School of Nursing,Southern Medical University,Guangzhou 510515,China;Pediatric Stomatology,Stomatological Hospital,School of Stomatology,Southern Medical University,Guangzhou 510280,China)

机构地区：[1]南方医科大学珠江医院临床护理教研室,广州510282 [2]南方医科大学护理学院,广州510515 [3]南方医科大学口腔医院(口腔医学院)儿童口腔科,广州510280

出　　处：《中国实用护理杂志》2024年第35期2743-2748,共6页Chinese Journal of Practical Nursing

摘　　要：目的评价儿童疼痛行为量表(FLACC)、东安大略儿童医院疼痛量表(CHEOPS)和客观疼痛量表(OPS)用于儿童口腔治疗全身麻醉恢复期疼痛评估的信度、效度和疼痛风险筛查能力,为患儿选择合适的疼痛评估工具提供参考。方法便利抽样法选取2024年1—5月南方医科大学口腔医院104例全身麻醉口腔治疗患儿,2名研究者于患儿入麻醉后恢复室第15分钟和第60分钟,同时独立使用随机排序的3种量表观察评估其疼痛,清醒患儿同时用Wong-Baker面部表情疼痛评定量表自评疼痛。评价3种量表的内部一致性、评估者间信度、结构效度和校标效度。结果最终纳入97例患儿,男50例,女47例,年龄(4.88±1.10)岁。入室第15分钟和第60分钟,FLACC、CHEOPS和OPS疼痛评分内部一致性信度Cronbachα系数依次为0.993、0.980、0.990和0.991、0.974、0.989;评估者间组内相关系数依次为0.993、0.985、0.998和0.985、0.984、0.984;均分别提取1个特征根>1.0的公因子,累计方差贡献率依次为95.116%、82.145%、78.417%和89.706%、67.652%、75.978%。入室第60分钟,3种量表与Wong-Baker面部表情疼痛评定量表评分Spearman相关系数依次为0.621、0.703、0.588;3种量表的Kappa系数和ROC曲线下面积依次为0.608、0.683、0.520和0.812、0.839、0.812。结论3种量表评估全身麻醉口腔治疗患儿恢复期疼痛具有良好的信度和较好的效度,从疼痛筛查角度依次推荐CHEOPS、FLACC、OPS。Objective To evaluate the reliability and validity of the Face,Legs,Activity,Cry,and Consolability(FLACC)Pain Behavioral Scale,the Children′s Hospital of Eastern Ontario Pain Scale(CHEOPS),and the Objective Pain Scale(OPS)during the general anesthesia recovery period in children with oral therapy,and to explore their screening ability for pain risk,so as to provide information for selecting appropriate pain assessment scales for pediatric patients.Methods One hundred and four pediatric patients with oral therapy under general anesthesia were recruited at the Stomatological Hospital of Southern Medical University from January to May,2024.Two researchers observed simultaneously and scored independently using three scales in random order at 15 minutes and 60 minutes after patients arrival at post anesthesia care unit(PACU).Those awake patients also used the Wong-Baker FACES Pain Rating Scale to report their pain.Internal consistency,inter-rater coefficient,construct and criterion validity of three scales were evaluated.Results The final sample included 97 patients(50 males and 47 females),with an age of(4.88±1.10)years.At 15 minutes and 60 minutes upon arrival at PACU,the Cronbach alpha coefficients for internal consistency of the FLACC,the CHEOPS,and the OPS were 0.993,0.980,0.990,and 0.991,0.974,0.989,respectively;the inter-rater correlation coefficients were 0.993,0.985,0.998,and 0.985,0.984,0.984,respectively;exploratory factor analysis extracted one factor from each scale,and cumulative variance contribution rates were 95.116%,82.145%,78.417%,and 89.706%,67.652%,75.978%,respectively.At 60 minutes upon arrival at PACU,the Spearman correlation coefficients between three scales and the Wong-Baker FACES Pain Rating scale were 0.621,0.703,0.588,respectively;Kappa coefficients of three scales were 0.608,0.683,0.520,and area under the ROC curve were 0.812,0.839,0.812,respectively.Conclusions The three scales show good reliability and acceptable validity for assessing pain during the general anesthesia recovery peri

关 键 词：疼痛 儿童 全身麻醉 口腔治疗 评估 信度 效度 

分 类 号：R473.72[医药卫生—护理学]