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ELABORATION AND VALIDATION OF EVENDOL: A BEHAVIOURAL PAIN SCALE FOR YOUNG CHILDREN ATTENDING THE ACCIDENT AND EMERGENCY DEPARTMENT
  1. E Fournier-Charriere1,
  2. C H Ricard2,
  3. F Lassauge3,
  4. B Tourniaire4,
  5. P Cimerman5,
  6. P Turquin6,
  7. B Falissard7,
  8. A Letierce8,
  9. F Reiter1,
  10. B Lombart4,
  11. R Carbajal5
  1. 1Service Douleur, Hopital Bicetre, AP-HP, Le Kremlin Bicetre, France
  2. 2Service Douleur, Hopital Lapeyronie, Montpellier, France
  3. 3Service Douleur, Hopital Saint Jacques, Besancon, France
  4. 4Service Douleur, Hopital Trousseau, AP-HP, Paris, France
  5. 5CNRD, Hopital Trousseau, AP-HP, Paris, France
  6. 6Urgences Enfant, Hopital Bicetre, AP-HP, Le Kremlin Bicetre, France
  7. 7INSERM U669, Hopital Cochin, AP-HP, Paris, France
  8. 8Service de Recherche Clinique, Hopital Bicetre, AP-HP, Le Kremlin Bicetre, France

Abstract

In the emergency department, pain has to be assessed quickly, in order to choose the appropriate analgesic. A simple behavioural scale was needed for young children under 6 years.

Elaboration EVENDOL was elaborated by paediatric pain specialists and emergency staff members. The scale includes five items: complaint, grimace, movements, postures, interaction with surroundings, each scored from 0 to 3.

Validation The scale was tested at three times: before any care, during mobilisation, after analgesic. Construct validity and interrater reliability were studied. Children were assessed by the nurse and the searcher, with EVENDOL and with a visual analogue scale (VAS) and with other scales. Anxiety and asthenia levels were assessed. Self-assessment scores were obtained from children above 4 years of age.

Results 297 children (1 month to 6 years) were included.

Construct Validity Scores before/after nalbuphine varied from 8.14 to 3.62 at rest (p<0.0001), from 11.87 to 6.65 at mobilisation (p = 0.0011); correlations between VAS and EVENDOL: 0.79 to 0.92 at all times (p<0.0001); correlations between EVENDOL and other behavioural pain scales (EDIN, CHEOPS, FLACC, TPPPS): 0.5 to 0.93 (concurrent validity); correlations between FPS-R and EVENDOL in 4–6-year-old children varied between 0.64 and 0.93; correlations between EVENDOL and tiredness and anxiety were bad (0.15 to 0.34) (discriminant validity).

Content Validity Excellent Cronbach coefficient (0.83 to 0.92). Interrater reliability between nurses and researcher: correlations 0.89 to 0.98, weighted kappa 0.7 to 0.9.

Conclusion EVENDOL, a new five-item scale to assess young children’s pain in the emergency department is validated. EVENDOL is simple and well accepted by nurses.

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