Figure - available from: Paediatric and Neonatal Pain
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Two examples of the Charleston Pediatric Pain Pictures illustrating a painful situation and its corresponding vignettes.²⁰
Source publication
It is often a challenge for a child to communicate their pain, and their possibilities to do so should be strengthened in healthcare settings. Digital self-assessment provides a potential solution for person-centered care in pain management and promotes child participation when a child is ill. A child's perception of pain assessment differs when it...
Citations
... It uses a universal design including colors, numbers, and face emojis to differentiate levels of pain intensity and may enhance children's self-reporting of pain (13). There are ongoing studies to test the agreement between the eFTS, the Coloured Analog Scale (CAS) and the Faces Pain Scale-Revised (FPS-R) (19). The aim of the present study was to establish content validity of the eFTS for pain assessments and the research questions were: ...
... This study uses a mixed method-explanatory design. The study is a single center study and a part of the international eFTS validation project (19). Descriptive and comparative statistical analysis was used, together with a qualitative approach for analyzing think-aloud conversations. ...
... The eFTS, available in a smartphone or in a tablet computer, uses colors ranging from green to red; numbers, 0 (nothing) to 10 (very much); and face emojis where green is symbolized with a happy face emoji and red is symbolized with a sad face emoji (19) (Figure 2). ...
Introduction
Early recognition of pain in children is crucial, and their self-report is the primary source of information. However, communication about pain in healthcare settings can be challenging. For non-verbal communication regarding different symptoms, children prefer digital tools. The electronic Faces Thermometer Scale (eFTS) utilizes a universal design with colors, face emojis, and numbers on an 11-point scale (0–10) for pain assessment. The aim of this study was to establish content validity of the eFTS for pain assessments in children.
Methods
A mixed methods design was used. The study took place at a university hospital in eastern Sweden, involving 102 children aged 8–17 years who visited outpatient clinics. Participants were presented with 17 pictures representing varying pain levels and asked to assess hypothetical pain using the eFTS. A think-aloud approach was employed, prompting children to verbalize their thoughts about assessments and the eFTS. Quantitative data were analyzed using descriptive and comparative statistics, together with a qualitative approach for analysis of think-aloud conversations.
Results
A total of 1,734 assessments of hypothetical pain using the eFTS were conducted. The eFTS differentiated between no pain (level 0–1) and pain (level 2–10). However, no clear agreement was found in the differentiation between hypothetical pain intensity levels (level 2–10). The analysis revealed that children utilized the entire scale, ranging from no pain to high pain, incorporating numbers, colors, and face emojis in their assessments.
Discussion
The variability in assessments was influenced by prior experiences, which had an impact on the statistical outcome in our study. However, employing the think-aloud method enhances our understanding of how children utilize the scale and perceive its design, including the incorporation of emotion-laden anchors. Children express a preference for using the eFTS to assess their pain during hospital visits.
