Development and Validation of a Nausea Severity Scale for Assessment of Nausea in Children with Abdominal Pain-Related Functional Gastrointestinal Disorders.

Alexandra Russell,Amanda Stone,Andi Wang,Lynn Walker

doi:10.3390/children5060068

Abstract

The objective of this study was to develop a pediatric measure of chronic nausea severity, the Nausea Severity Scale (NSS), and evaluate its reliability and validity in youth with abdominal pain-related functional gastrointestinal disorders (AP-FGID). Pediatric patients (aged 11–17 years-old, n = 236) presenting to an outpatient clinic for evaluation of abdominal pain completed the NSS, Children’s Somatization Inventory (CSI), Functional Disability Inventory (FDI), Abdominal Pain Index (API), Patient-Report Outcomes Measurement Information System (PROMIS), Anxiety and Depression Scales and the Pediatric Rome III Questionnaire for FGIDs. The NSS demonstrated good concurrent, discriminant, and construct validity, as well as good internal consistency. One-third (34%) of AP-FGID patients reported experiencing nausea “most” or “every day” in the previous two weeks. The severity of nausea was higher in females than males and correlated significantly with the severity of somatic symptoms, functional disability, anxiety, and depression. The NSS is a valid and reliable measure of nausea in children with AP-FGID.

Highlights

Nausea is a common symptom that accompanies many acute pediatric illnesses and typically resolves with treatment and resolution of illness [1]
This study evaluated the psychometric properties of a patient-report measure of chronic nausea severity, the Nausea Severity Scale (NSS), in a clinical sample of pediatric patients with abdominal pain-related functional gastrointestinal disorders (AP-FGID)
The validity of the NSS was evident in its high correlations with the single item measure of nausea severity on the Children’s Somatization Inventory (CSI) and with measures of other symptoms known to be associated with nausea, including somatic symptoms, functional disability, anxiety, and depression

Summary

Introduction

Nausea is a common symptom that accompanies many acute pediatric illnesses and typically resolves with treatment and resolution of illness [1]. Chronic or recurrent nausea without identifiable etiology, in contrast, may be refractory to treatment [2]. Nausea is common in pediatric patients with abdominal pain-related functional gastrointestinal disorders (AP-FGID) and is estimated to affect between 45% [3,4] and 85% [5] of this patient population. In youth with AP-FGIDs, the presence of nausea has been associated with greater disability, fatigue, anxiety, and negative effect and is rarely explained by identifiable organic etiology [2,3,6,7]. A recent study found youth with AP-FGIDs and nausea, compared to youth with AP-FGIDs alone, reported more severe gastrointestinal, extra-intestinal, and internalizing symptoms (anxiety and depression) [3]

Objectives

Methods

Results

Conclusion