A Brief Measure Assessing Adolescents' Daily In-Hospital Function Predicts Pain and Health Outcomes at Home After Major Surgery.

Abstract

Pain-related function is not routinely assessed in the hospital. This prospective cohort study examined whether patients' daily pain-related function during hospitalization, based on the validated Youth Acute Pain Functional Ability Questionnaire (YAPFAQ), is associated with pain and quality of life. The YAPFAQ is a 12-item measure assessing functional parameters of recovery related to pain and has been validated in children and adolescents with sickle cell disease and after surgery. Adolescents undergoing major musculoskeletal surgery (n = 93) completed the YAPFAQ daily for up to 3 days after surgery. Adolescents self-reported health-related quality of life on the Pediatric Quality of Life Inventory and pain intensity on a numeric rating scale at home 2weeks after surgery. Higher YAPFAQ scores, representing poorer function, were associated with higher pain intensity (β = 0.2, P = 0.04) and poorer health-related quality of life (β = -0.3, P = 0.01) at home 2 weeks after surgery. This functional measure could be clinically relevant to providers to identify adolescents at risk of difficulty with pain and recovery at home after surgery who might need further intervention to minimize functional impairment and delayed recovery. This article provides conceptual validation of a functional score for pediatric pain, the YAPFAQ, to assess pain intensity and health-related quality of life in the subacute period.