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Validity and reliability of a Swedish version of the Non-Communicating Children’s Pain Checklist – Postoperative Version

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Abstract Aim: 

To test the validity and reliability of a Swedish version of the Non-Communicating Children’s Pain Checklist – Postoperative Version (NCCPC-PV). Methods: 

Thirty-two consecutive children/adolescents (2–20 years of age) with cognitive impairment and no verbal communication from four habilitation centres were admitted to the study. Each child’s behaviour was observed by a parent or a caregiver and by a physiotherapist in two calm and two painful situations within the child’s everyday life. The raters independently assessed and graded the child’s behaviour during 5 min according to the translated Swedish version of the NCCPC-PV. The intrarater and interrater reliability were determined, and the construct validity was examined. Results: 

The results from 202 assessments showed that the construct validity was good: children’s behavioural signs differed significantly between situations of pain and situations of calm (p < 0.001). Repeated assessments showed poor agreement both within and between raters [intraclass correlation coefficient (ICC) 0.51–0.65]. The agreement for pain was good (ICC 0.83). Conclusion: 

The Swedish version of the NCCPC-PV can be used for pain assessment in children with cognitive impairments who lack verbal communication. Aspects of reliability need to be further analysed.

Keywords: Children; Cognitive impairment; Observational pain tool; Pain assessment; Pain measurement

Document Type: Research Article


Affiliations: 1: Handicap & Habilitation, Stockholm, Sweden 2: Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden

Publication date: June 1, 2010


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