Using colors to assess pain in toddlers: validation of "the rainbow pain scale"-a proof-of-principle study

J Pediatr Oncol Nurs. 2015 Jan-Feb;32(1):40-6. doi: 10.1177/1043454214555197. Epub 2014 Nov 21.

Abstract

Self-report, when available, is considered the ideal way to assess the intensity and other aspects of pain in children. However, self-report scales are often too complex cognitively for preschool-aged children (2-4 years). The Rainbow Pain Scale (RPS) was developed to provide individualized self-reported pain ratings for preschool-aged children. The psychometric properties of this scale have yet to be evaluated. To ensure validity, our first step was to compare RPS scores to a well-validated scale in older children who were able to self-report their pain. The purpose of this study was to assess the concurrent validity of the RPS in children aged 5 to 10 years as proof of principle. We compared ratings of 49 children's pain using the RPS with those on the Faces Pain Scale-Revised (FPS-R). Participants suffering from pain related to cancer and cancer treatment were recruited to complete both scales at 3 time points, during both inpatient and outpatient clinic visits. Pearson's r and Cohen's κ were used to evaluate the level of association between the scales. The association between RPS and the FPS-R was greater than .7 at all 3 visits; r = .96 between the scales at the first clinic visit, .97 at the second visit, and .93 at the third visit. Cohen's κ between scales was 1.0 at the first clinic visit, .95 at the second visit, and .87 at the third visit. The RPS shows excellent concurrent validity with the FPS-R in school-aged children. The next step will be to examine the psychometric properties of the RPS in preschool-aged children.

Keywords: oncology; pain; pain scale; preschool children.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Age Factors
  • Child
  • Child, Preschool
  • Color*
  • Female
  • Humans
  • Infant
  • Inpatients / psychology*
  • Male
  • Neoplasms / psychology*
  • Oncology Nursing / methods
  • Outpatients / psychology*
  • Pain / diagnosis*
  • Pain / psychology*
  • Pain Measurement / methods*
  • Pediatric Nursing / methods
  • Psychometrics / instrumentation
  • Self Report