Pain assessment in children with life-limiting conditions is complex due to varying patient needs and communication challenges. This review analyzes pain assessment tools used in UK pediatric palliative care, evaluating their effectiveness and practicality. A systematic literature review examined peer-reviewed research published up to April 2021, sourced from databases like PsycINFO, Web of Science, Medline, EMBASE, BIOSIS, and CINAHL.
Common Pain Assessment Tools Used in Pediatric Palliative Care
The review identified 22 pain assessment tools from 34 eligible studies. While the number of studies per tool and overall methodological quality were limited, several tools demonstrated strong psychometric properties. The Faces Pain Scale-Revised (FPS-R) showed high validity and responsiveness across cultures. The Faces, Legs, Activity, Cry, and Consolability (FLACC) scale and the Paediatric Pain Profile (PPP) exhibited high internal consistency, reliability, and responsiveness.
Choosing the Right Pain Assessment Tool
Selecting an appropriate tool requires considering both feasibility and psychometric robustness. The FPS-R is recommended for self-assessment in children able to communicate their pain levels. For observational assessment, the FLACC scale (or its revised version) is suitable for younger children, while the PPP is recommended for older children and adolescents.
Recommendations for UK Clinical Practice
This review highlights the importance of utilizing validated pain assessment tools in pediatric palliative care. The FPS-R, FLACC, and PPP are recommended based on their psychometric properties. However, clinicians should consider individual patient needs and developmental stages when choosing a tool. Further research is needed to strengthen the evidence base and improve the quality of pain assessment in this vulnerable population. This systematic review provides valuable insights into pain assessment tools for children in palliative care within the UK healthcare system.
