Journal Article

Verifying the validity and reliability of the Japanese version of the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale

Matsuishi Yujiro, Kido Takahiro, 下條 信威, Inoue Yoshiaki, Enomoto Yuki, Hoshino Tetsuya, Hoshino Haruhiko, 井上 貴昭, Shimojo Nobutake, Sumitani Masahiko

2018

Overview

Background\\nPediatric patients, especially in the preverbal stage, cannot self-report intensity of pain therefore several validated observational tools, including the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale, have been used as a benchmark to evaluate pediatric pain. Unfortunately, this scale is currently unavailable in Japanese, precluding its widespread use in Japanese hospitals.\\n\\nObjectives\\nTo translate and verify the validity and reliability of the Japanese version of the FLACC Behavioral Scale.\\n\\nMethod\\nBack-translation was first conducted by eight medical researchers, then an available sample of patients at the University of Tsukuba Pediatric Intensive Care Unit (from May 2017 to August 2017) was enrolled in a clinical study. Two researchers evaluated the validity of the translated FLACC Behavioral Scale by weighted kappa coefficient and intraclass correlation coefficients (ICC). Observational pain was simultaneously measured by the visual analog scale (VAS obs) and reliability was evaluated by correlation analysis.\\n\\nResult\\nThe original author approved the translation. For the clinical study, a total of 121 observations were obtained from 24 pediatric patients. Agreement between observers was highly correlated for each of the FLACC categories (Face: κ = 0.85, Leg: κ = 0.74, Activity: κ = 0.89, Cry: κ = 0.93, Consolability: κ = 0.93) as well as the total score (Total: κ = 0.95,). Correlation analysis demonstrated a good criterion validation between the FLACC scale and the VAS obs. (r = 0.96)\\n\\nConclusion\\nOur Japanese version of the FLACC Behavioral Scale shows high validity and reliability.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Asthma / Behavior Rating Scale - standards / Behavior rating scales / Biology and Life Sciences / Child / Child, Preschool / Correlation / Correlation analysis / Correlation coefficient / Correlation coefficients / Critical care / Delirium / Evaluation / Face / Facial Expression / Female / Health status indicators / Hospitals / Humans / Infant / Infant, Newborn / Intensive care / Intensive Care Units, Pediatric / Japan / Leg / Legs / Male / Medical care quality / Medical protocols / Medical research / Medicine / Medicine and Health Sciences / Methods / Mortality / Nociception / Nurses / Pain / Pain Measurement - methods / Pain Measurement - standards / Patients / Pediatrics / People and Places / Preschool children / Psychometrics - methods / Reliability analysis / Reproducibility of Results / Research and Analysis Methods / Researchers / Studies / Testing / Translating / Translation / Translations / Translations and translating / Validity / Ventilators / Visual observation